A straightforward, systematic and reproducible framework for junior registrars to adopt when learning the handsewn ileostomy closure technique.
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Laparoscopic Reversal of Roux-en-Y Gastric Bypass with Hand-Sewn Gastro-Gastrostomy and Resection of the Alimentary Limb.
Obes Surg
December 2024
Department of Upper Gastrointestinal and Bariatric Surgery, University Hospitals Sussex (St Richard's Hospital), Chichester, UK.
Introduction: Roux-en-Y gastric bypass (RYGB) reversal might be necessary to alleviate refractory surgical or nutritional complications, such as postprandial hypoglycemia, malnutrition, marginal ulceration, malabsorption, chronic diarrhea, nausea and vomiting, gastro-esophageal reflux disease, chronic pain, or excessive weight loss. The surgical technique of RYGB reversal is not standardized; potential strategies include the following: (1) gastro-gastrostomy: hand-sewn technique, linear stapler, circular stapler; (2) handling of the Roux limb: reconnection or resection (if remaining intestinal length ≥ 4 m).
Case Presentation: We demonstrate the surgical technique of a laparoscopic reversal of RYGB with hand-sewn gastro-gastrostomy and resection of the alimentary limb with the aim of improving the patient's quality of life.
Current approach to loop ileostomy closure: a nationwide survey on behalf of the Italian Society of ColoRectal Surgery (SICCR).
Updates Surg
November 2024
Gastrointestinal Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Article Synopsis
- A study comparing loop ileostomy reversal to standardized colorectal procedures found significant variations in surgical practices among Italian surgeons, highlighting both the techniques used and adherence to recovery protocols.
- An online survey involving 219 colorectal surgeons revealed diverse methods for assessing anastomosis integrity, with no clear consensus on the use of prostheses during abdominal wall closure.
- The survey indicated a high level of compliance with the Enhanced Recovery After Surgery (ERAS) protocol, particularly among colorectal specialists compared to general surgeons, suggesting the need for standardized practices like purse-string closure.
Analysis of risk factors for surgical site infection and other postoperative complications in patients following loop ileostomy reversal.
Pol Przegl Chir
April 2024
Department of General, Endocrinological Surgery and Gastroenterological Oncology, Poznan University of Medical Sciences, Poland.
<b>Introduction:</b> Loop ileostomy reversal (LIR) procedure is still associated with a relatively high risk of complications. Surgical site infection (SSI) is the most common complication in this group of patients. SSI leads to prolonged hospital stays, delays the adjuvant therapy, and increases hospital costs.
View Article and Find Full Text PDFThe impact of anastomotic leakage characteristics on the occurrence of anastomotic stenosis after colorectal resection, a retrospective cohort study.
Int J Colorectal Dis
August 2024
Department of Surgery, Medical Faculty Mannheim, Universitätsmedizin Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Introduction: Anastomotic stenosis (AS) is a common complication after colorectal resection. However, the predisposing factors for stricture formation are not fully understood. Previous studies have shown anastomotic leakage (AL) to be a risk factor for the occurrence of AS.
View Article and Find Full Text PDFLong-Term Results of 2-Stage Turnbull-Cutait Pull-Through Coloanal Anastomosis for Low Rectal Cancer: A Randomized Clinical Trial.
JAMA Surg
September 2024
Department of General and Digestive Surgery, Colorectal Unit, Bellvitge University Hospital, University of Barcelona and IDIBELL, Barcelona, Spain.
Importance: In patients operated on for low rectal cancer, 2-stage Turnbull-Cutait pull-through hand-sewn coloanal anastomosis provides benefits in terms of postoperative morbidity compared with standard hand-sewn coloanal anastomosis associated with diverting ileostomy and further ileostomy reversal.
Objective: To compare long-term results of these 2 techniques after ultralow rectal resection for rectal cancer.
Design, Setting, And Participants: In this randomized multicenter clinical trial, neither patients nor surgeons were blinded for technique.
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