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Related Concept Videos

Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

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Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
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Ostomy Care01:24

Ostomy Care

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Introduction
An ostomy is a surgical procedure that creates an artificial opening from the intestines to the outside of the body, allowing for the rerouting of effluent. This opening is known as a stoma. A stoma usually protrudes above the skin surface, appearing pink or red, moist, and round, and it lacks nerve sensations.
There are different types of ostomies, including colostomies, ileostomies, and urostomies:
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Appendicitis-II: Diagnostic Studies and Management01:29

Appendicitis-II: Diagnostic Studies and Management

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Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
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Inflammatory Bowel Disease I: Ulcerative Colitis01:27

Inflammatory Bowel Disease I: Ulcerative Colitis

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Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
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Inflammatory Bowel Disease II: Crohn's Disease01:30

Inflammatory Bowel Disease II: Crohn's Disease

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Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
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Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
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From Formation to Closure: Aggregate Morbidity and Mortality Associated With Defunctioning Loop Ileostomies.

Mei Yang1, J Andrew McClure2, Kerollos N Wanis1

  • 1Department of Surgery, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada.

Diseases of the Colon and Rectum
|November 29, 2021
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Summary
This summary is machine-generated.

Defunctioning loop ileostomies are associated with significant morbidity and mortality. Approximately 13.2% of patients undergoing this procedure will have a permanent ostomy, highlighting the need for careful consideration of risks and benefits.

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Area of Science:

  • Colorectal Surgery
  • Surgical Outcomes
  • Patient Morbidity

Background:

  • Defunctioning loop ileostomies are frequently employed in surgical practice.
  • However, these procedures are associated with considerable rates of morbidity and mortality.

Purpose of the Study:

  • To comprehensively describe the morbidity and mortality linked to the creation and subsequent closure of defunctioning loop ileostomies.
  • To quantify the rates of complications and permanent ostomy.

Main Methods:

  • A descriptive study utilizing electronic health records and claims data.
  • Inclusion criteria: adult patients undergoing low anterior resection with a concurrent defunctioning loop ileostomy between 2002 and 2014.
  • Outcomes: 30-day major complications, acute kidney injury, transfusion, deep space infection, ileostomy reversal rates, and permanent ostomy rates.

Main Results:

  • The study cohort included 4658 patients.
  • Overall 30-day, 90-day, and 1-year mortality rates were 1.2%, 2.2%, and 5.1%, respectively.
  • Major complications occurred in 28.5% of patients, with 13.2% ultimately requiring a permanent ostomy. Post-reversal, major complications dropped to 10.3%.

Conclusions:

  • Defunctioning loop ileostomies carry significant morbidity and mortality risks.
  • A notable proportion of patients (13.2%) are left with a permanent ostomy after the procedure.
  • These findings underscore the importance of careful patient selection and management.