تعداد نشریات | 20 |
تعداد شمارهها | 1,149 |
تعداد مقالات | 10,518 |
تعداد مشاهده مقاله | 45,415,438 |
تعداد دریافت فایل اصل مقاله | 11,291,230 |
The Impact of Ghost Ileostomy on Anastomotic Leakage: Selecting Eligible Patients for Surgery and Early Detection of Leakage | ||
Iranian Journal of Colorectal Research | ||
مقاله 3، دوره 12، شماره 1، خرداد 2024، صفحه 11-15 اصل مقاله (625.6 K) | ||
نوع مقاله: Research/Original Article | ||
شناسه دیجیتال (DOI): 10.30476/acrr.2024.101734.1207 | ||
نویسندگان | ||
Alimohamamad Bananzadeh1؛ Amir Askari* 2؛ Leila Ghahramani3؛ Mahshid Bahadori3؛ Sara Shojaei-Zarghani3؛ Seyed Vahid Hosseini3 | ||
1Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran | ||
2Department of General Surgery, Shiraz University of Medical Sciences, Shiraz, Iran | ||
3Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran | ||
چکیده | ||
Background: Anastomotic leakage (AL) is the main complication of colorectal surgeries. Recent studies have assessed the effects of the ghost ileostomy on preventing complications related to a defunctioning stoma (DS) in high-risk anastomoses. In this study, we aimed to review patients who underwent ghost ileostomy and assess their colon leakage score (CLS) and Dutch leakage score (DULK) to evaluate their preoperative AL risk and post-operative AL diagnostic score, respectively. We examined whether the suggested cut-off points of these scores (>11 for CLS and >4 for DULK) could be appropriate criteria for determining when to insert ghost ileostomy and when to convert it to a DS. Methods: All patients from three referral hospitals in Shiraz, Iran who underwent colorectal surgery with ghost ileostomy during 2019-2020 were enrolled in this retrospective case series. We calculated preoperative CLS and post-operative DULK scores for all patients and assessed what diagnostic and therapeutic measures were performed for them based on their scores. Results: AL was diagnosed in two of 34 patients. Eight patients had a total CLS score of 11 and above, but only one of them experienced AL. The other case of AL had a CLS score of 10. The DULK score of these two patients increased during hospitalization. Conclusion: Because of the importance of accurately identifying high-risk patients for ghost ileostomy, it is imperative to undertake additional research aimed at determining the optimal cut-off value for CLS or devising alternative valid scoring systems. DULK score could be an appropriate post-operative monitoring tool to reduce morbidity. | ||
کلیدواژهها | ||
Anastomotic leakage؛ Ghost ileostomy؛ Stoma؛ Colorectal surgery | ||
مراجع | ||
1. Gulla N, Trastulli S, Boselli C, Cirocchi R, Cavaliere D, Verdecchia GM, et al. Ghost ileostomy after anterior resection for rectal cancer: a preliminary experience. Langenbecks Arch Surg. 2011;396(7):997-1007. 2. McDermott F, Heeney A, Kelly M, Steele R, Carlson G, Winter D. Systematic review of preoperative, intraoperative, and postoperative risk factors for colorectal anastomotic leaks. British Journal of Surgery. 2015;102(5):462-79. 3. Vallance A, Wexner S, Berho M, Cahill R, Coleman M, Haboubi N, et al. A collaborative review of the current concepts and challenges of anastomotic leaks in colorectal surgery. Colorectal Dis. 2017;19(1):O1-O12. 4. Rahbari NN, Weitz J, Hohenberger W, Heald RJ, Moran B, Ulrich A, et al. Definition and grading of anastomotic leakage following anterior resection of the rectum: a proposal by the International Study Group of Rectal Cancer. Surgery. 2010;147(3):339-51. 5. Kulu Y, Ulrich A, Bruckner T, Contin P, Welsch T, Rahbari NN, et al. Validation of the International Study Group of Rectal Cancer definition and severity grading of anastomotic leakage. Surgery. 2013;153(6):753-61. 6. Ellebæk M, Qvist N. Early detection and the prevention of serious complications of anastomotic leakage in r ectal cancer s urgery. Springer; 2014. 7. Dupré A, Slim K. Fistule anastomotique après chirurgie colorectale: peut-on la détecter plus facilement et plus tôt? : Elsevier Masson; 2012. p. 329-30. 8. Rathnayake M, Kumarage S, Wijesuriya S, Munasinghe B, Ariyaratne M, Deen K. Complications of loop ileostomy and ileostomy closure and their implications for extended enterostomal therapy: a prospective clinical study. International journal of nursing studies. 2008;45(8):1118-21. 9. Sacchi M, Legge PD, Picozzi P, Papa F, Giovanni CL, Greco L. Virtual ileostomy following TME and primary sphinctersaving reconstruction for rectal cancer. Hepato-gastroenterology. 2007;54(78):1676-8. 10. McKechnie T, Lee J, Lee Y, Tessier L, Amin N, Doumouras A, et al. Ghost Ileostomy Versus Loop Ileostomy Following Oncologic Resection for Rectal Cancer: A Systematic Review and Meta-Analysis. Surgical Innovation. 2023:15533506231169066. 11. Dekker JWT, Liefers GJ, van Otterloo JCdM, Putter H, Tollenaar RA. Predicting the risk of anastomotic leakage in left-sided colorectal surgery using a colon leakage score. Journal of Surgical Research. 2011;166(1):e27-e34. 12. Den Dulk M, Witvliet M, Kortram K, Neijenhuis P, De Hingh I, Engel A, et al. The DULK (D utch leakage) and modified DULK score compared: actively seek the leak. Colorectal Disease. 2013;15(9):e528-e33. 13. Miccini M, Amore Bonapasta S, Gregori M, Barillari P, Tocchi A. Ghost ileostomy: real and potential advantages. Am J Surg. 2010;200(4):e55-7. 14. Samji KB, Kielar AZ, Connolly M, Fasih N, Doherty G, Chung A, et al. Anastomotic leaks after small-and large-bowel surgery: diagnostic performance of CT and the importance of intraluminal contrast administration. American Journal of Roentgenology. 2018:1259-65. 15. Nicksa G, Dring R, Johnson K, Sardella W, Vignati P, Cohen J. Anastomotic leaks: what is the best diagnostic imaging study? Diseases of the colon & rectum. 2007;50:197-203. 16. Zizzo M, Morini A, Zanelli M, Tumiati D, Sanguedolce F, Palicelli A, et al. Short-Term Outcomes in Patients Undergoing Virtual/Ghost Ileostomy or Defunctioning Ileostomy after Anterior Resection of the Rectum: A Meta-Analysis. Journal of Clinical Medicine. 2023;12(11):3607. 17. Warschkow R, Beutner U, Steffen T, Müller SA, Schmied BM, Güller U, et al. Safe and early discharge after colorectal surgery due to C-reactive protein: a diagnostic meta-analysis of 1832 patients. Annals of surgery. 2012;256(2):245-50. 18. Takakura Y, Hinoi T, Egi H, Shimomura M, Adachi T, Saito Y, et al. Procalcitonin as a predictive marker for surgical site infection in elective colorectal cancer surgery. Langenbeck’s archives of surgery. 2013;398:833-9. 19. Lagoutte N, Facy O, Ravoire A, Chalumeau C, Jonval L, Rat P, et al. C-reactive protein and procalcitonin for the early detection of anastomotic leakage after elective colorectal surgery: pilot study in 100 patients. Journal of visceral surgery. 2012;149(5):e345-e9. | ||
آمار تعداد مشاهده مقاله: 65 تعداد دریافت فایل اصل مقاله: 151 |