Results of stoma formation for idiopathic megarectum and megacolon

1992 ◽  
Vol 7 (2) ◽  
pp. 82-84 ◽  
Author(s):  
G. Stabile ◽  
M. A. Kamm ◽  
P. R. Hawley ◽  
J. E. Lennard-Jones
Keyword(s):  
Stoma Formation ◽  
Idiopathic Megarectum

scholarly journals Surgical management of Encapsulating Peritoneal Sclerosis (EPS) in children: international case series and literature review

2021 ◽  
Author(s):  
Videha Sharma ◽  
Zia Moinuddin ◽  
Angela Summers ◽  
Mohan Shenoy ◽  
Nicholas Plant ◽  
...  
Keyword(s):  
Case Series ◽  
Wound Management ◽  
Supplementary Information ◽  
Operative Morbidity ◽  
Post Surgery ◽  
Paediatric Patients ◽  
Stoma Formation ◽  
Gut Function ◽  
Health And Development ◽  
Secondary Closure

Abstract Background Encapsulating Peritoneal Sclerosis (EPS) is a rare phenomenon in paediatric patients with kidney failure treated with peritoneal dialysis (PD). This study highlights clinical challenges in the management of EPS, with particular emphasis on peri-operative considerations and surgical technique. Methods Retrospective analysis of all paediatric patients with EPS treated at the Manchester Centre for Transplantation. Results Four patients were included with a median duration of 78 months on PD. All patients had recurrent peritonitis (> 3 episodes), and all had symptoms within three months of a change of dialysis modality from PD to haemodialysis or transplant. In Manchester, care was delivered by a multi-disciplinary team, including surgeons delivering the adult EPS surgical service with a particular focus on nutritional optimisation, sepsis control, and wound management. The surgery involved laparotomy, lavage, and enterolysis of the small bowel + / − stoma formation, depending on intra-abdominal contamination. Two patients had a formal stoma, which were reversed at three and six months, respectively. Two patients underwent primary closure of the abdomen, whereas two patients had re-look procedures at 48 h with secondary closure. One patient had a post-operative wound infection, which was managed medically. One patient’s stoma became detached, leading to an intra-abdominal collection requiring re-laparotomy. The median length of stay was 25 days, and patients were discharged once enteral feeding was established. All patients remained free of recurrence with normal gut function and currently two out of four have functioning transplants. Conclusions This series demonstrates 100% survival and parenteral feed independence following EPS surgery. Post-operative morbidity was common; however, with individualised experience-based decision-making and relevant additional interventions, patients made full recoveries. Health and development post-surgery continued, allowing the potential for transplantation. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information

Stoma Closure Improves Head Circumference Growth in Very Preterm Infants after Necrotizing Enterocolitis

2020 ◽  
Author(s):  
Karina Dyrvig Honoré ◽  
Malene Nygaard Johansen ◽  
Lars Rasmussen ◽  
Gitte Zachariassen
Keyword(s):  
Preterm Infants ◽  
Necrotizing Enterocolitis ◽  
Head Circumference ◽  
International Classification Of Diseases ◽  
University Hospital ◽  
Stoma Closure ◽  
Poor Growth ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Stoma Formation

Abstract Introduction Very preterm infants (VPIs) surgically treated for necrotizing enterocolitis (NEC) are at risk of growth retardation. The aim of this study was to demonstrate and compare growth during the first 6 years of life in VPIs with stoma after NEC surgery with VPIs without NEC surgery. Materials and Methods We included all VPIs surgically treated due to NEC at the Odense University Hospital from August 1, 2004, to July 31, 2008. Outcome on growth was compared with a group of VPIs without NEC. The VPIs with NEC were identified searching the local database using the International Classification of Diseases, 10th Revision diagnosis of NEC (DP77.9). Data on growth were collected from medical files and if not present, the parents reported the data. Results Nineteen VPIs, surgically treated due to NEC, survived to 6 years of age. Median gestational age was 283/7 weeks (245/7–313/7). Median age at NEC surgery and stoma formation was 2.3 weeks (0.1–6.3) and median age at stoma closure was 2.5 months corrected age (CA) (postmenstrual age 36 weeks to CA 6.7 months). Compared with the non-NEC group, VPIs with NEC and stoma demonstrated poor growth, especially in head circumference (HC) with no increase in growth velocity before the time of stoma closure between 2.5- and 3-month CAs. Conclusion Our findings demonstrate poor growth in VPIs after NEC surgery and improved HC growth after stoma closure.

scholarly journals The Role of Mesh Implants in Surgical Treatment of Parastomal Hernia

Materials ◽  
2021 ◽  
Vol 14 (5) ◽  
pp. 1062
Author(s):  
Karolina Turlakiewicz ◽  
Michał Puchalski ◽  
Izabella Krucińska ◽  
Witold Sujka
Keyword(s):  
Parastomal Hernia ◽  
3D Structure ◽  
Surgical Techniques ◽  
Current Standard ◽  
Intraperitoneal Onlay Mesh ◽  
Stoma Formation ◽  
Causal Treatment ◽  
Onlay Mesh ◽  
Prophylactic Use ◽  
Mesh Implant

A parastomal hernia is a common complication following stoma surgery. Due to the large number of hernial relapses and other complications, such as infections, adhesion to the intestines, or the formation of adhesions, the treatment of hernias is still a surgical challenge. The current standard for the preventive and causal treatment of parastomal hernias is to perform a procedure with the use of a mesh implant. Researchers are currently focusing on the analysis of many relevant options, including the type of mesh (synthetic, composite, or biological), the available surgical techniques (Sugarbaker’s, “keyhole”, or “sandwich”), the surgical approach used (open or laparoscopic), and the implant position (onlay, sublay, or intraperitoneal onlay mesh). Current surface modification methods and combinations of different materials are actively explored areas for the creation of biocompatible mesh implants with different properties on the visceral and parietal peritoneal side. It has been shown that placing the implant in the sublay and intraperitoneal onlay mesh positions and the use of a specially developed implant with a 3D structure are associated with a lower frequency of recurrences. It has been shown that the prophylactic use of a mesh during stoma formation significantly reduces the incidence of parastomal hernias and is becoming a standard method in medical practice.

scholarly journals Ostomy-Related Complications

2019 ◽  
Vol 32 (03) ◽  
pp. 176-182 ◽  
Author(s):  
Douglas Murken ◽  
Joshua Bleier
Keyword(s):  
Gastrointestinal Tract ◽  
Surgical Procedures ◽  
Parastomal Hernia ◽  
Significant Morbidity ◽  
Stoma Formation ◽  
Wide Range ◽  
Peristomal Skin ◽  
Stomal Stenosis

AbstractIleostomy or colostomy formation is an important component of many surgical procedures performed for a wide range of disorders of the gastrointestinal tract. Despite the frequency with which intestinal stomas are created, stoma-related complications remain common and are associated with significant morbidity as well as cost. Some of the most prevalent complications of stoma formation which will be detailed in this article include peristomal skin complications, retraction, stomal necrosis, stomal stenosis, prolapse, bleeding, dehydration from high ostomy output, and parastomal hernia. The authors will review these common complications, detail means to avoid or prevent them, and outline recommendations for management.

Outcomes following stoma formation in patients with spinal cord injury

2019 ◽  
Vol 21 (12) ◽  
pp. 1415-1420 ◽  
Author(s):  
E. A. Cooper ◽  
B. Bonne Lee ◽  
M. Muhlmann
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Stoma Formation ◽  
Cord Injury

Vertical reduction rectoplasty: a new treatment for idiopathic megarectum

2000 ◽  
Vol 87 (9) ◽  
pp. 1203-1208 ◽  
Author(s):  
N. S. Williams ◽  
O. A. Fajobi ◽  
P. J. Lunniss ◽  
S. M. Scott ◽  
A. J. P. Eccersley ◽  
...  
Keyword(s):  
New Treatment ◽  
Idiopathic Megarectum

Idiopathic megacolon and megarectum in an adult treated with laparoscopic modified Duhamel procedure

2021 ◽  
Vol 14 (6) ◽  
pp. e240209
Author(s):  
Maureen Elvira Padernal Villanueva ◽  
Marc Paul Jose Lopez ◽  
Mark Augustine S Onglao
Keyword(s):  
Emergency Department ◽  
Chronic Constipation ◽  
Ganglion Cells ◽  
Rectal Biopsy ◽  
Full Thickness ◽  
Postoperative Course ◽  
Idiopathic Megacolon ◽  
Duhamel Procedure ◽  
Idiopathic Megarectum ◽  
Sigmoid Loop Colostomy

Idiopathic megacolon (IMC) and idiopathic megarectum (IMR) describe an abnormality of the colon or rectum, characterised by a permanent dilatation of the bowel diameter in the absence of an identifiable cause. We present a 23-year-old woman with chronic constipation and excessive straining during defecation who presented at the emergency department in partial gut obstruction with a palpable fecaloma. Manual faecal disimpaction and a sigmoid loop colostomy was initially done. A full thickness rectal biopsy was positive for ganglion cells. Further workup led to the diagnosis of chronic IMC and IMR. The patient underwent laparoscopic modified Duhamel procedure, with an uneventful postoperative course.

Surgical treatment of idiopathic megarectum in constipated children

2019 ◽  
Vol 54 (7) ◽  
pp. 1379-1383 ◽  
Author(s):  
Igor V. Kirgizov ◽  
Sergey V. Minaev ◽  
Ilya Shishkin ◽  
Svetlana Aprosimova ◽  
Luiza Ukhina
Keyword(s):  
Surgical Treatment ◽  
Idiopathic Megarectum

scholarly journals Ileostomy or colostomy for temporary decompression of colorectal anastomosis: systematic review and meta-analysis

2008 ◽  
Vol 23 (3) ◽  
pp. 294-303 ◽  
Author(s):  
Katia Ferreira Güenaga ◽  
Suzana Angélica Silva Lustosa ◽  
Sarhan Sydney Saad ◽  
Humberto Saconato ◽  
Delcio Matos
Keyword(s):  
Large Scale ◽  
Loop Ileostomy ◽  
Skin Irritation ◽  
Colorectal Anastomosis ◽  
Length Of Hospital Stay ◽  
Transverse Colostomy ◽  
Time Interval ◽  
Stoma Formation ◽  
Statistical Heterogeneity ◽  
Stoma Prolapse

PURPOSE: The controversy regarding whether loop ileostomy or loop transverse colostomy is a better method for temporary decompression of colorectal anastomosis motivated this review. METHODS: Five randomized trials were included, with 334 patients: 168 in the loop ileostomy group and 166 in the loop transverse colostomy group. The outcomes analyzed were: 1. Mortality; 2. Wound infection; 3. Time of stoma formation; 4. Time of stoma closure; 5. Time interval between stoma formation and closure; 6. Stoma prolapse; 7. Stoma retraction; 8. Parastomal hernia; 9. Parastomal fistula; 10. Stenosis; 11. Necrosis; 12. Skin irritation; 13. Ileus; 14. Bowel leakage; 15. Reoperation; 16. Patient adaptation; 17. Length of hospital stay; 18. Colorectal anastomotic dehiscence; 19. Incisional hernia; 20. Postoperative bowel obstruction. RESULTS: Stoma prolapse was statistically significant (p = 0.00001), but with statistical heterogeneity; the sensitive analysis was applied, excluding the trials that included emergency surgery, and this showed: p = 0.02, with I² = 0% for the heterogeneity test. CONCLUSIONS: The outcomes reported were not statistically or clinically significant except for stoma prolapse. Better evidence for making the choice between loop ileostomy or loop colostomy requires large-scale randomized controlled trials.

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