Defunctioning of the anorectum: historical controlled study of laparoscopic vs. open procedures

Diseases of the Colon and Rectum
C J YoungM J Solomon

Abstract

Creating a defunctioning stoma for anorectal disease in patients in whom no resection or anastomosis is required appears eminently suited for laparoscopic techniques, with the intended advantages of early recovery, reduced pain, and avoidance of a laparotomy. The study contained herein was undertaken to determine the feasibility of laparoscopic defunctioning stoma formation using a three-port technique (including one at the stoma site) and to compare initial results with a historical control group. Duration of operation (anesthetic plus surgery), the time to tolerance of a liquid and then a solid diet, time to passage of flatus and feces, patient morphine requirements in the first 48 hours, and day of discharge were documented. Nineteen laparoscopic stomas were attempted (3 converted to open) and 23 open stomas were formed in the control group. The laparoscopic stoma group had lower morphine requirements (mean, 47.7 vs. 89.9 mg; P < 0.01), an earlier tolerance of both liquid (mean, 2.1 vs. 3.7 days; P < 0.01) and solid diets (mean, 3.6 vs. 5.5 days; P < 0.001), and an earlier time to passage of both flatus (mean, 2.2 vs. 3.6 days; P < 0.001) and feces (mean, 3.7 vs. 5.6 days; P < 0.001). Operating time was longer for the laparo...Continue Reading

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Citations

Aug 11, 2007·Langenbeck's Archives of Surgery·H ScheidbachH Lippert
Oct 4, 2003·ANZ Journal of Surgery·Peter W G CarneFrank A Frizelle
Mar 10, 2015·Diseases of the Colon and Rectum·Samantha HendrenJanice Rafferty
Oct 14, 2019·Techniques in Coloproctology·F FerraraUNKNOWN Multidisciplinary Italian Study group for STOmas (MISSTO)
Feb 19, 2020·The Journal of Trauma and Acute Care Surgery·Dominic Mario ForteMatthew J Martin
Apr 27, 2004·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Ravi L HuilgolMichael J Solomon
Jun 15, 2006·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Henrik Loft JakobsenJacob Rosenberg
Apr 9, 2014·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Erman AytacMeagan M Costedio
Jan 31, 2014·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Eiji TanakaToshiharu Yamaguchi
Nov 10, 2011·Diseases of the Colon and Rectum·Karen N ZaghiyanPhillip R Fleshner
May 21, 2013·Asian Journal of Endoscopic Surgery·Junichi HasegawaRiichiro Nezu
May 11, 2018·Annals of Coloproctology·Seung-Seop YeomJin Cheon Kim
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Sep 25, 1999·Diseases of the Colon and Rectum·M D HellingerL R Sands
May 28, 2008·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Claudio De CarliSteven Rubin

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