Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Randomized trial of loop ileostomy in restorative proctocolectomy.

S P Grobler1, K B Hosie, M R Keighley

  • 1University Department of Surgery, Queen Elizabeth Medical Centre, Birmingham, UK.

The British Journal of Surgery
|September 1, 1992
PubMed
Summary

Avoiding a loop ileostomy after restorative proctocolectomy is safe and reduces hospital stay. Loop ileostomies lead to frequent complications, suggesting they are unnecessary for patients with a secure ileoanal anastomosis.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Randomized controlled trial of stroke volume optimization during elective major abdominal surgery in patients stratified by aerobic fitness.

British journal of anaesthesia·2015
Same author

Patients' inability to perform a preoperative cardiopulmonary exercise test or demonstrate an anaerobic threshold is associated with inferior outcomes after major colorectal surgery.

British journal of anaesthesia·2013
Same author

Does every patient need to be discussed at a multidisciplinary team meeting?

Clinical radiology·2013
Same author

Percutaneous endoscopic colostomy; an alternative treatment of acute colonic pseudo-obstruction.

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland·2013
Same author

Attendance at iron deficiency anaemia clinic: audit of outcomes 5 years on.

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland·2012
Same author

Randomized controlled trial of intraoperative goal-directed fluid therapy in aerobically fit and unfit patients having major colorectal surgery.

British journal of anaesthesia·2011

Area of Science:

  • Colorectal Surgery
  • Surgical Outcomes
  • Gastroenterology

Background:

  • Restorative proctocolectomy is a surgical procedure for ulcerative colitis and familial adenomatous polyposis.
  • A loop ileostomy is sometimes used to protect the ileoanal anastomosis after this surgery.
  • The necessity and impact of loop ileostomies on patient outcomes require further investigation.

Purpose of the Study:

  • To evaluate the role and complications of a loop ileostomy in patients undergoing totally stapled restorative proctocolectomy.
  • To compare outcomes between patients with and without a protective loop ileostomy.

Main Methods:

  • A randomized controlled trial was conducted.
  • Eligible patients (n=45) without corticosteroid use and with a watertight pouch and intact ileoanal anastomosis were randomized to receive a loop ileostomy (n=23) or no ileostomy (n=22).

Related Experiment Videos

  • Outcomes including anastomotic leaks, stenosis, sepsis, obstruction, pouchitis, ileostomy complications, and hospital stay were assessed.

    • Main Results:

    • No deaths occurred; anastomotic leaks were similar in both groups (one in each).
    • Ileoanal stenosis was more frequent in the ileostomy group (5 vs. 1).
    • Ileostomy-related complications occurred in 52% of patients with an ileostomy, and the median hospital stay was significantly longer (23 days vs. 13 days, P < 0.001).

    Conclusions:

    • Avoiding a protective loop ileostomy in totally stapled restorative proctocolectomy is associated with a low risk of pelvic sepsis.
    • Loop ileostomy is linked to a high incidence of complications and prolonged hospital stay.
    • Routine use of loop ileostomy may not be necessary in selected patients undergoing restorative proctocolectomy.