Gasless laparoscopic-assisted ileostomy or colostomy closure using an abdominal wall-lifting device
| Autor: | R. Borroni, M. Bossotti, Mattio R, M. Dellepiane, A. Coda, Bona A, F. Ferri, F. Martino |
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| Rok vydání: | 1999 |
| Předmět: |
Adult
Male medicine.medical_specialty Lifting medicine.medical_treatment Stoma Abdominal wall Ileostomy Pneumoperitoneum Colostomy medicine Humans Laparoscopy Reduction (orthopedic surgery) Abdominal Muscles Aged medicine.diagnostic_test business.industry General surgery Anastomosis Surgical Middle Aged medicine.disease Surgery medicine.anatomical_structure Intestinal Perforation Gases business Abdominal surgery |
| Zdroj: | Surgical endoscopy. 15(6) |
| ISSN: | 1432-2218 |
| Popis: | Background: Restoration of intestinal continuity in patients with ileostomy after total colectomy or with colostomy after Hartmann's procedure is a major operation. Herein we illustrate the validity of gasless laparoscopically assisted reversal using abdominal wall lifting. Methods: The operation was performed on 10 patients from February 1997 to May 1999. Seven of them had a left iliac stoma after a Hartmann resection, and three had an ileostomy after total colectomy. Results: The laparoscopic reversal was completed in eight patients; the two others were converted to an open procedure. Three major complications occurred (30%). There were no deaths. The average operation time was 192 min (range, 125-265). Time of discharge from surgery averaged 9.5 days. Mean follow-up of these patients was 12 months and negative. Conclusions: Laparoscopically assisted ileo- or colorectal anastomosis without pneumoperitoneum and using a laparotenser can be considered for the reversal of patients with ileostomy or colostomy. Even taking the high rate of intraoperative or postoperative complications into consideration, the advantages that make such a laparoscopic approach suitable include reduced trauma related to a second major abdominal operation, reduced postoperative pain, and fewer cutaneous tissues exposed to bacterial contamination. Moreover, the use of a laparotenser makes it possible to operate on elderly patients with cardiovascular diseases. In the absence of pneumoperitoneum, it becomes possible to use traditional instruments, with a consequent reduction in costs. |
| Databáze: | OpenAIRE |
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