Skin bridge loop stoma: outcome in 45 patients in comparison with stoma made on a plastic rod

Carannante, Filippo; Mascianà, Gianluca; Lauricella, Sara; Caricato, Marco; Capolupo, Gabriella Teresa

doi:10.1007/s00384-019-03415-x

Cited by 19 publications

(25 citation statements)

References 10 publications

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“…In this study, the trauma VAS scores were lower in the OG than in the CG upon the day of surgery and at 7 days postoperatively, but there was no significant difference within the CG at 3 and 5 days postoperatively, suggesting that the combined procedure can exert pain control earlier than a single fistula removal and that pain can be eliminated more rapidly. Similar data indicate that for AFs, fistula excision coupled with drainage skin-bridge surgery significantly decreases postoperative discomfort [ 21 ]. In this study, the length of hospital stay and trauma healing time were shorter in the OG than in the CG, which shows that combined drainage skin-bridge preservation in addition to fistula excision can accelerate the postoperative recovery of patients and promote healing.…”

Section: Discussionsupporting

confidence: 73%

“…By maintaining the skin bridge over the fistula and draining the fistula using rubber strips, the drainage skin-bridge sparing operation coupled with fistula removal differs from simple fistula excision, thus eliminating the need for full incision of the fistula causing tissue damage, resulting in low level of pain and more rapid reduction of postoperative pain [ 8 , 21 ]. In this study, the trauma VAS scores were lower in the OG than in the CG upon the day of surgery and at 7 days postoperatively, but there was no significant difference within the CG at 3 and 5 days postoperatively, suggesting that the combined procedure can exert pain control earlier than a single fistula removal and that pain can be eliminated more rapidly.…”

Section: Discussionmentioning

confidence: 99%

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Effectiveness and Prognosis: Drainage Skin-Bridge Sparing Surgery Combined with Fistulotomy versus Fistulotomy Only in the Treatment of Anal Fistula

Wang

2021

Journal of Healthcare Engineering

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Objective. This study intends to analyze the difference in the efficacy of drainage skin-bridge sparing surgery combined fistulotomy (DSCF) and fistulotomy alone. Methods. 125 patients with anal fistula were enrolled as study subjects and randomly divided into control group (CG) and observation group (OG) by double-blind lottery. The CG received drainage skin-bridge sparing surgery with fistulotomy and the OG received fistulotomy only. Results. The VAS scores of the trauma in the OG were lower than those in the CG on 1st day of surgery and 7 days after surgery ( P < 0.05 ). The length of hospital stay and time to wound healing were shorter in the OG than in the CG ( P < 0.05 ). The incidence of postoperative bleeding in the OG was 9.52%, which was lower than 22.58% in the CG ( P < 0.05 ). The rectal examination scores were lower in the OG than in the CG at 3 and 5 days postoperatively ( P < 0.05 ). The Wexner scores of solid incontinence (0 to 4), liquid incontinence (0 to 4), gas incontinence (0 to 4), pad wearing (0 to 4), and lifestyle alteration (0 to 4) in the OG were lower than those of the CG at 5 days postoperatively ( P < 0.05 ). Voiding function scores were lower in the OG than in the CG at 2 and 3 days postoperatively ( P < 0.05 ). Conclusions. The efficacy of drainage skin-bridge sparing surgery combined fistulotomy is better than that of fistulotomy alone, which can accelerate postoperative healing, enhance urinary function, reduce postoperative bleeding, and improve anal function.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Effectiveness and Prognosis: Drainage Skin-Bridge Sparing Surgery Combined with Fistulotomy versus Fistulotomy Only in the Treatment of Anal Fistula

Wang

2021

Journal of Healthcare Engineering

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“…All patients had a single circular-stapled ileo-anal pouch anastomosis as described above. All patients received a defunctioning skin bridge loop right ileostomy 27 (Table 2). Table 2.…”

Section: Resultsmentioning

confidence: 99%

Transanal Proctocolectomy And Ileal Pouch-Anal Anastomosis (TaIPAA) For Ulcerative Colitis: Medium Term Functional Outcomes In A Single Centre.

Capolupo

Carannante

Mascianà

et al. 2020

Preprint

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Background: Transanal dissection of the rectum has been recently introduced for ileal pouch-anal anastomosis (IPAA) in UC showing promising results. Thanks to the precise identification of the rectotomy site the risk of long rectal stump is avoided, and a single stapled anastomosis is performed easily.The aim of this study is to analyze our initial experience of transanal IPAA (Ta-IPAA), considering postoperative complications and medium-term functional outcomes.Methods: Our Center has experienced the transanal approach for proctectomy and IPAA since October 2018. All patients underwent Enhanced Recovery After Surgery (ERAS) protocol. Postoperative complications occurring within 30 days after surgery were taken into consideration. Fecal continence, genito-urinary activity and global quality of life at 1 and 6 months after ileostomy reversal have been assessed.Results: Until March 2019, 8 patients underwent Ta-IPAA. In all cases the laparoscopic approach was performed during the transabdominal phase; abdominal drainage was never used. At the time of the pouch construction a defunctioning loop ileostomy was created in all patients. Stoma closure was performed in all cases at a median time of 6 months after surgery. Postoperative complications occurred in only one patient, who showed rectal bleeding. There were no cases of anastomotic leakage.Medium-term functional outcomes were determined prospectively by a validated questionnaire (Cleveland Global Quality of Life). Fecal incontinence for liquid or solid stool, genitourinary and sexual functions were also investigated, showing comparable results with the literature data.Conclusions: In our experience, Ta-IPAA provided good short and medium-term functional results in UC.

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“…Using a skin bridge might reduce the stoma-related complications and comparatively better early post-operative care of a loop stoma. 17 …”

Section: Discussionmentioning

confidence: 99%

Early parastomal evisceration of small bowel following a loop ileostomy for malignant intestinal obstruction

Basnayake

Prasanthan

Jayarajah

et al. 2021

SAGE Open Medical Case Reports

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Evisceration of bowel through the stoma is a rare complication and only few cases have been reported. Although most cases occur in the context of long-standing parastomal hernias, early evisceration may also occur causing significant morbidity to patients. The reported patient is a 53-year-old male with bronchial asthma who was diagnosed to have metastatic colonic cancer underwent a trephine loop ileostomy for intestinal obstruction. On post-operative Day 7, he developed small bowel evisceration through the ileostomy site. The patient underwent an emergency laparotomy and found to have non-viable prolapsed small bowel segment at the stoma site. Furthermore, there were extensive peritoneal deposits and large para aortic lymph node mass and ascites compromising the peritoneal space. Resection of non-viable small bowel and ileostomy refashioning was carried out. The patient was managed in the intensive care unit and he gained function of the ileostomy on post-operative Day 2. On Day 5, he died due to subsequent pneumonia and worsening acute respiratory distress syndrome. Early parastomal evisceration is an extremely infrequent life-threatening complication that requires urgent treatment. Disseminated cancer, bowel obstruction, poor nutritional status, ascites and exacerbation of bronchial asthma were additional risk factors in our patient.

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Skin bridge loop stoma: outcome in 45 patients in comparison with stoma made on a plastic rod

Cited by 19 publications

References 10 publications

Effectiveness and Prognosis: Drainage Skin-Bridge Sparing Surgery Combined with Fistulotomy versus Fistulotomy Only in the Treatment of Anal Fistula

Effectiveness and Prognosis: Drainage Skin-Bridge Sparing Surgery Combined with Fistulotomy versus Fistulotomy Only in the Treatment of Anal Fistula

Transanal Proctocolectomy And Ileal Pouch-Anal Anastomosis (TaIPAA) For Ulcerative Colitis: Medium Term Functional Outcomes In A Single Centre.

Early parastomal evisceration of small bowel following a loop ileostomy for malignant intestinal obstruction

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