[25 years experience with the anastomotic stoma]

Area of Science:

• Gastrointestinal Surgery
• Surgical Innovation
• Emergency Abdominal Surgery

Background:

• The anastomotic stoma has been utilized for over 25 years in emergency bowel surgery.
• It serves as an alternative to high-risk primary anastomosis or a second laparotomy for bowel reconstruction.
• The procedure is feasible when adequate bowel loop mobilization is achievable.

Purpose of the Study:

• To evaluate the efficacy and safety of the anastomotic stoma technique in emergency bowel surgery.
• To assess the rate of bowel continuity restoration and the necessity of secondary laparotomy.
• To highlight the protective benefits of the anastomotic stoma on the anastomosis itself.

Main Methods:

• The technique involves resecting diseased bowel, anastomosing the posterior wall of proximal and distal loops, and exteriorizing the anterior wall as a stoma.
• The stoma is fixed to the abdominal wall.
• This method was applied in 136 patients, with 117 undergoing emergency operations.

Main Results:

• No mortality was directly attributed to the anastomotic stoma procedure.
• Bowel continuity was successfully restored in 100 out of 136 patients.
• Forty-eight patients died due to their primary underlying disease, not the surgical method.

Conclusions:

• The anastomotic stoma is a safe and effective technique in emergency bowel surgery, with no procedure-related deaths.
• It protects the anastomosis from pressure and allows for daily monitoring.
• The method facilitates the restoration of bowel continuity, often obviating the need for a secondary laparotomy.