Construction and Closure of Loop Ileostomy for Temporary Fecal Diversion in Colorectal Cancer Operations

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  • Hamada Tomonori
    Department of Surgery, National Hospital Organization Hokkaido Cancer Center
  • Naito Haruhiko
    Department of Surgery, National Hospital Organization Hokkaido Cancer Center
  • Shinohara Toshiki
    Department of Surgery, National Hospital Organization Hokkaido Cancer Center
  • Maeda Yoshiaki
    Department of Surgery, National Hospital Organization Hokkaido Cancer Center

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  • 大腸癌手術における一時的ループイレオストミーの造設と閉鎖についての検討

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Purpose: The aim of this study was to assess all morbidity and mortality associated with temporary loop ileostomy (LI) in colorectal cancer operations.<br> Methods: An analysis was performed of 39 patients who underwent LI construction and closure between 1995 and 2007.<br> Results: Twenty patients required temporary fecal diversion for protection against low colorectal anastomosis, while nineteen patients required LI after anastomotic leakage. The round shaped LI formed a spout without a rod. The average stoma size was 30mm×30mm×26mm (height). Complications arising from LI construction included three peristomal skin disorders, two stomal ulcers, and two small bowel obstructions. There was no retraction, prolapse, hernia, high stoma output, or mortality. The closure was stapled (functional side-to-side) in 24 patients while a hand-sewn anastomosis (end-to-end) was done in 15 patients. In the hand-sewn group, five patients had anastomotic small-bowel obstruction, and one patient had a anastomotic leak required reoperation.<br> Conclusion: LI is a safe procedure for fecal diversion with acceptable and generally minor complications. Stapled closure is safe with low risk of bowel obstruction.<br>

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