Related Experiment Video
Updated: Sep 14, 2025
Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction
Published on: March 24, 2023
IMMEDIATE AND LATE RESULTS OF ILEOSTOMY CLOSURE IN PATIENTS WITH FAMILIAL ADENOMATOUS POLYPOSIS UNDERGOING
Fábio Guilherme Campos1, Carlos Augusto Real Martinez2, Carlos Frederico Sparapan Marques3
1Departamento de Gastroenterologia, Staff do Serviço de Cirurgia do Cólon, Reto e Ânus da Disciplina de Coloproctologia, Hospital das Clínicas (HCFMUSP), São Paulo, SP, Brasil.
Background:
Restorative proctocolectomy (RPC) is a common surgical indication to manage familial adenomatous polyposis (FAP) patients.
Objective:
We compared outcomes after ileostomy closure in patients undergoing laparoscopic (LAP) or conventional (OPEN) RPC at one single institution.
Methods:
Charts from FAP patients (1997-2013) were reviewed. Demographic data (age, sex, previous surgery) and surgical outcomes (original surgical approach, early and late morbidity, complications and reoperations after ileostomy closure) were compared.
Results:
A total of 84 patients (53 women and 31 men) submitted to ileostomy closure at a mean age of 30.6 years (11-64) were analyzed. Twenty-one (25%) and 63 patients (75%) formed the OPEN and LAP groups, respectively. Demographic features were similar. After pouch construction, 27 early (32.1%) and 8 late (9.5%) complications occurred, with no mortality. Although overall morbidity rates were similar between both approaches, late complications rate were less common in LAP patients (7.9% x 14.2%). After ileostomy closure, complications were registered in 6 (7.1%) patients, and patients previously operated with the LAP approach also presented less complications (4.7% x 14.2%) and reoperations (3.1% x 9.5%). Additionally, the need for surgical management of complications was greater in the OPEN (9.5%) than the LAP group (3.1%). Besides these numbers, analysis didn't reveal statistical differences among both groups.
Conclusion:
In the conditions of the present manuscript, the abdominal approach used for restorative proctocolectomy doesn't seem to decisively influence outcomes after loop ileostomy reversal. In the future, analysis of a greater number of patients may probably demonstrate an expected greater complication and reoperation rates in those previously treated through OPEN procedures.
Background:
• Ileostomy closure is an important part of the surgical treatment of FAP patients undergoing restorative proctocolectomy by any approach.
Background:
• Complication rates after loop ileostomy reversal occurred in 7% of a group of 84 FAP patients.
Background:
• Among those operated with the laparoscopic approach, complications (4.7% x 14.2%) an reoperations (3.15% X .5%) were less common when compared to the group treated with conventional approach.
Background:
• In the future, annalysis of a greater number of patients may probably reveal an statistical difference between these numbers, thus clearly demonstrating this great advantage of minimally invasive procedures in this group of patients.
Related Concept Videos
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:24Ostomy Care
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:
01:25Peptic Ulcer Disease V: Surgical Management and Nursing Care
Surgical Interventions for Peptic Ulcer Disease
01:29Appendicitis-II: Diagnostic Studies and Management
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...