Role of ghost ileostomy in low anterior resection for carcinoma rectum

2021 ◽  
Vol 91 (5) ◽  
pp. 1039-1039
Author(s):  
Mudassir A. Khan ◽  
Nisar A. Chowdri ◽  
Fazl Q. Parray ◽  
Rauf A. Wani ◽  
Asif Mehraj ◽  
...  
Keyword(s):  
Anterior Resection ◽  
Low Anterior Resection ◽  
Ghost Ileostomy ◽  
Carcinoma Rectum

Role of peptide YY and enteroglucagon after low anterior resection

1996 ◽  
Vol 39 (10) ◽  
pp. 1153-1158 ◽  
Author(s):  
Olof Hallböök ◽  
Thomas E. Adrian ◽  
Johan Permert ◽  
Paul Staab
Keyword(s):  
Anterior Resection ◽  
Low Anterior Resection ◽  
Peptide Yy

scholarly journals A Decalogue to Avoid Routine Ileostomy in Selected Patients With Border Line Risk to Develop Anastomotic Leakage After Minimally Invasive Low-Anterior Resection: A Pilot Study

2019 ◽  
Vol 27 (1) ◽  
pp. 44-53
Author(s):  
Salvador Morales-Conde ◽  
Isaias Alarcón ◽  
Tao Yang ◽  
Eugenio Licardie ◽  
Andrea Balla
Keyword(s):  
Anastomotic Leakage ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Fluorescence Angiography ◽  
Splenic Flexure Mobilization ◽  
Horizontal Section ◽  
Border Line ◽  
Ghost Ileostomy ◽  
Protective Ileostomy ◽  
Methylene Blue Test

Purpose. Protective ileostomy (PI) during anterior resection (AR) for rectal cancer decreases the incidence of anastomotic leakage (AL) and its subsequent complications, but it may itself be the cause of morbidity. The aim is to report our protocol in the management of selected patients with borderline risk to develop AL after laparoscopic AR and ghost ileostomy (GI) creation. Methods. Patients who underwent AR were stratified based on the risk to develop AL. Steps to avoid PI were splenic flexure mobilization, reduced pelvic bleeding, to employ different stapler charge if neoadjuvant chemo-radiotherapy is performed, to perform a horizontal section of the rectum, to evaluate the anastomotic vascularization with a fluorescence angiography, to perform a side-to-end anastomosis, intraoperative methylene blue test, pelvic and transanal drainage tubes placement, and the GI creation. After surgery, inflammatory blood markers were monitored to detect potential leakages. Results. Twelve patients were included. In one case, the specimen proximal section was changed after fluorescence angiography. There were no conversions in this group of patients. One postoperative AL occurred and was treated with radiological drainage placement, not being necessary to convert the GI. PI was avoided in 100% of cases. Conclusions. Patients’ characteristics cannot be changed, but several steps were used to avoid routine PI creation. The present protocol could be a valuable option to avoid PI in selected patients. Further studies with a wider sample size, and defined criteria to stratify the patients based on the risk to develop AL, are required.

scholarly journals The Role of Diverting Stoma After an Ultra-low Anterior Resection for Rectal Cancer

2013 ◽  
Vol 29 (2) ◽  
pp. 66 ◽  
Author(s):  
Seok In Seo ◽  
Chang Sik Yu ◽  
Gwon Sik Kim ◽  
Jong Lyul Lee ◽  
Yong Sik Yoon ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Diverting Stoma

The Role of Traditional Acupuncture in Low Anterior Resection Syndrome Treatment

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Audrius Dulskas ◽  
Tomas Aukstikalnis ◽  
Povilas Kavaliauskas ◽  
Narimantas E. Samalavicius
Keyword(s):  
Anterior Resection ◽  
Low Anterior Resection ◽  
Low Anterior Resection Syndrome ◽  
Anterior Resection Syndrome

scholarly journals Role of Covering Ileostomy in Causation of Anastomotic Strictures in Low Anterior Resections for Rectum Carcinoma

2021 ◽  
Vol 41 (02) ◽  
pp. 131-137
Author(s):  
Mudassir Ahmad Khan ◽  
Rauf A. Wani ◽  
Asif Mehraj ◽  
Arshad Baba ◽  
Mushtaq Laway ◽  
...  
Keyword(s):  
Anterior Resection ◽  
Low Anterior Resection ◽  
Tertiary Care ◽  
Control Group ◽  
Study Group ◽  
Anastomotic Site ◽  
Rectum Carcinoma ◽  
Anastomotic Strictures ◽  
The Difference

Abstract Background Colorectal resection anastomosis is the commonest cause of rectal strictures. Anastomotic site ischemia, incomplete doughnuts from stapled anastomosis and pelvic infection, are some of the risk factors that play a role in the development of postoperative rectal strictures. However, the role of diverting stoma in the development of rectal strictures has not been studied extensively. Objectives To study the difference in the occurrence of anastomotic strictures (AS) in patients submitted to low anterior resection (LAR) with covering ileostomy (CI), and to LAR without CI for carcinoma rectum. Methods This was a prospective, comparative case control study carried out at a tertiary care referral center. Low anterior resection with covering ileostomy was performed in patients with rectum carcinoma in the study group, while LAR without covering ileostomy was performed in the control group. The study group had 29 patients, while the control group had 33 patients with rectum carcinoma. Results During the mean follow-up period of 9.1months, 8 (28%) patients in the study group and 2 (6%) patients in the control group developed AS (p =0.019). Out of these 8 patients with AS in the study group, 50% had Grade-I AS, 25% had Grade-II AS, while 25% of the patients had Grade-III (severe) AS. However, both patients who developed AS in the control group had a mild type (Grade I) of AS. Conclusion Covering ileostomy increases the chances of AS formation after LAR for rectum carcinoma. Also, the SKIMS Clinical Grading of Rectal Strictures is a simple and handy tool available for every surgeon to grade, classify and monitor the postoperative rectal strictures.

scholarly journals Developing Surgical Oncology Services in Resource Constrained Settings: Results of a Systematic and Motivated Approach

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 94s-94s
Author(s):  
R. Mohan ◽  
P. Jaiswal
Keyword(s):  
Anterior Resection ◽  
Low Anterior Resection ◽  
Surgical Oncology ◽  
Resource Constrained ◽  
Carcinoma Breast ◽  
Nodal Yield ◽  
Carcinoma Rectum ◽  
General Service ◽  
Carcinoma Ovary

Background: General surgeons trained in surgical oncology and working in a general service hospital can offer and provide a wide variety of oncological services although significant limitations exist compared with a true tertiary cancer care center in developed high income countries. Providing optimal and standard of care surgical oncology services is truly demanding and limitations in ancillary and support services can potentially limit the quality of care provided in resource constrained settings like ours. Aim: The aim of this study was to analyze the patterns of care, surgical outcomes in terms of morbidity and mortality, quality of resection in terms of margins and nodal yield over a period of 08 weeks in a general service hospital with resource constrained setting and with two trained and motivated surgical oncologists. Methods: Data of 22 patients with solid organ cancers who underwent major operative treatment both curative and palliative under the surgical oncology services were analyzed retrospectively. All patients were evaluated clinically, imaging as required and pathologic tissue diagnosis of cancer obtained as was possible and after adequate preoperative preparation were operated upon. Results: Four patients of carcinoma rectum underwent low anterior resection with diverting ileostomy, one patient with rectal cancer had APR with permanent end colostomy, two patients underwent total thyroidectomy for papillary thyroid cancer, eight patients underwent modified radical mastectomy for carcinoma breast, two patients had optimal cytoreductive surgery for carcinoma ovary -one patient upfront and another as interval cytoreduction, two cases of soft tissue tumor underwent limb salvage surgery, one case of carcinoma stomach underwent subtotal gastrectomy, one case of carcinoma cecum underwent classic right radical hemicolectomy. Two patients underwent emergency exploration for acute abdomen who were otherwise metastatic for palliation. All but one case received neoadjuvant therapy prior to surgery in carcinoma rectum, one case of carcinoma ovary and carcinoma breast were operated after neoadjuvant chemotherapy. Overall there was only one margin positive resection after low anterior resection who was operated upfront due to impending obstruction. The average nodal yield in all cases of colorectal carcinomas and breast cancer cases were as per current NCCN standards. Morbidities included seroma collection in 3 patients, minor surgical site infection in 2 patients, peristomal allergy in two patients, there were no deaths in elective cases. Conclusion: Providing quality surgical oncology services in a resource constrained general service hospital is challenging. Through an aggressive, well planned and motivated approach with a good surgical oncology training background and with available resources it is possible to achieve a varied spectrum, quality care and an improved and sustainable healthcare oncology systems for better outcomes even in these settings.

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