Does stoma site specimen extraction increase postoperative ileostomy complication rates?
Surg Endosc
; 31(9): 3552-3558, 2017 09.
Article
em En
| MEDLINE
| ID: mdl-28078466
ABSTRACT
BACKGROUND:
Minimizing incisions has the potential to decrease hernia formation and wound complications following laparoscopic surgery. It is currently unknown if using the stoma site for specimen extraction affects outcomes. This study aims to evaluate the impact of stoma site extraction on postoperative complication rates in laparoscopic colorectal surgery.METHODS:
After IRB approval, a retrospective comparative review of 738 consecutive patients (405 M) who underwent laparoscopic colorectal surgery with ileostomy between January 2008 and December 2014 was performed. Patients who had a minimally invasive surgery that required an ileostomy were included. Patients were classified into two groups stoma site extraction (SSE) or non-stoma site extraction (NSSE) and compared by body mass index (BMI), age, comorbidities, American Society of Anesthesiologists score, length of stay, estimated blood loss, parastomal complications, and hernia rate.RESULTS:
The parastomal hernia rate was 10.1% for the SSE group (n = 14) and 4.2% for the NSSE group (n = 25) (p = 0.007). The need for additional surgeries was 7/139 (5.0%) for the SSE group and 27/599 (4.5%) for the NSSE group (p = 0.79). There was no difference in the hernia rate after stoma closure in either group. There was no difference in single incision laparoscopic surgery versus conventional laparoscopy or robotic-assisted laparoscopy on stoma site complications in patients with SSE. SSE, transfusion, and BMI >30 were found to be independent factors associated with increased stoma site complications.CONCLUSION:
SSE does increase stoma site complications. SSE should be used with caution, or in conjunction with other techniques to reduce hernias in patients requiring a permanent stoma or with an elevated BMI. The increase in stoma site complications does not translate into additional surgeries or postoperative sequelae following stoma reversal and is a reasonable option in patients requiring a temporary stoma.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
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Reto
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Ileostomia
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Laparoscopia
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Colectomia
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Estomas Cirúrgicos
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Surg Endosc
Assunto da revista:
DIAGNOSTICO POR IMAGEM
/
GASTROENTEROLOGIA
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
China