We examined the feasibility of umbilical diverting ileostomy for overweight and obese patients with rectal cancer undergoing laparoscopic surgery. Four patients who were overweight or obese (BMI > 27 kg/m ) were initially scheduled for the creation of a conventional loop ileostomy. Intraoperatively, however, this was considered too complicated because of thick subcutaneous fat, bulky mesentery, or both. Instead, patients received a diverting ileostomy with the placement of an umbilical stoma. All patients had protruding umbilical ileostomies. No severe stoma-related complications were encountered. One patient had minor skin dehiscence, and another had paralytic ileus but resumed oral intake after a short time. Performing a temporary loop ileostomy at the umbilicus was safe and feasible in this small group of overweight and obese patients. This stoma placement may avoid the problems inherent to conventional loop ileostomy in obese subjects.
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http://dx.doi.org/10.1111/ases.12316 | DOI Listing |
Ann Surg Oncol
January 2025
Department Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.
Background: Anastomotic leakage (AL) is a major complication in colorectal surgery, particularly following rectal cancer surgery, necessitating effective prevention strategies. The increasing frequency of colorectal resections and anastomoses during cytoreductive surgery (CRS) for peritoneal carcinomatosis further complicates this issue owing to the diverse patient populations with varied tumor distributions and surgical complexities. This study aims to assess and compare AL incidence and associated risk factors across conventional colorectal cancer surgery (CRC), gastrointestinal CRS (GI-CRS), and ovarian CRS (OC-CRS), with a secondary focus on evaluating the role of protective ostomies.
View Article and Find Full Text PDFExpert Rev Gastroenterol Hepatol
January 2025
INFINY Institute, Department of Gastroenterology, CHRU Nancy, INSERM NGERE, Université de Lorraine, Vandœuvre-lès-Nancy, France.
Introduction: Acute severe ulcerative colitis (ASUC) is a critical manifestation of ulcerative colitis (UC), often necessitating colectomy when medical management fails. Despite advancements in therapeutic interventions such as corticosteroids, biologics, and JAK inhibitors, a significant proportion of patients require surgery, with colectomy rates ranging from 10% to 15%.
Areas Covered: This paper reviews the factors influencing the timing and necessity of colectomy in ASUC management, emphasizing the importance of multidisciplinary decision-making involving gastroenterologists and surgeons.
Cureus
December 2024
Department of Surgery, Kishiwada Tokushukai Hospital, Kishiwada, JPN.
A 61-year-old woman underwent an emergent operation with sigmoid colon cancer resection, colostomy, and ileostomy on colon perforation. The low ileostoma, caused by intra-abdominal bad conditions, had irritated the surrounding skin after surgery, intermittently forcing the patient to fast for a certain period. Six months after the operation, under the judgment that re-ileostomy, essential for hospital discharge, seemed very difficult through another laparotomy, we attempted to make the ileostoma higher not with pulling the ileum from the abdomen but with lowering the surrounding skin using skin flap formation techniques.
View Article and Find Full Text PDFInt J Surg Case Rep
December 2024
Faculty of Health, Universidad Santiago de Cali, Cali, Colombia. Electronic address:
Introduction: Metabolic acidosis, marked by decreased plasma bicarbonate and arterial pH, is a common complication following extensive abdominal surgeries. D-lactate acidosis presents additional diagnostic challenges due to nonspecific symptoms.
Presentation Of Case: A 65-year-old woman with hypertension and morbid obesity was admitted to the ICU for intestinal obstruction and peritonitis due to an incarcerated hernia.
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