Document Detail


Use of intracolonic bypass secured by a biodegradable anastomotic ring to protect the low rectal anastomosis.
MedLine Citation:
PMID:  18080714     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Because of the relatively high morbidity and mortality of anastomotic leakage in patients with low rectal cancer who receive an anterior resection, many fecal diverting methods have been introduced. This study was designed to assess the efficacy and safety of the Valtrac-secured intracolonic bypass in protecting low rectal anastomosis and to compare the efficacy and complications of Valtrac-secured intracolonic bypass with those of loop ileostomy. METHODS: From January 2002 to April 2006, 83 patients with rectal cancer who underwent elective low anterior resection received intracolonic bypass or ileostomy. Demographics, clinical features, and operative data were recorded. RESULTS: Forty-four patients (53 percent) received a Valtrac-secured intracolonic bypass and 39 patients (47 percent) a loop ileostomy. The demographics and clinical features of the groups were similar. None of the patients developed clinical anastomotic leakage. Longer overall postoperative hospital stay (21.3 +/- 5.8 days) and higher costs incurred (3.1 +/- 0.9 x $1,000 U.S. dollars) were observed in the ileostomy group than in the intracolonic bypass group (12.5 +/- 6.3 days, 4.4 +/- 1.2 x $1,000 U.S. dollars; P < 0.05). Stoma-related complications in the ileostomy group included dermatitis (12.8 percent), bleeding (2.6 percent), and intestinal obstruction after stoma closure (5.1 percent). No complications were observed in the intracolonic bypass group except for the Valtrac ring discharging en bloc, which compromised fecal evacuation in two cases (4.5 percent). CONCLUSIONS: The Valtrac-secured intracolonic bypass procedure is a safe, effective, but time-limited, diverting technique to protect an elective low colorectal anastomosis. Valtrac-secured intracolonic bypass, in contrast to loop ileostomy, avoids stoma-related complications or readmission for closure and is associated with decreased hospital time and cost.
Authors:
Feng Ye; Danyang Wang; Xiangming Xu; Fanlong Liu; Jianjiang Lin
Related Documents :
4017824 - Sphincter-saving procedure for treatment of diffuse cavernous hemangioma of the rectum ...
15570794 - Non-restorative surgery for rectal cancer: indications in 2003.
15603644 - The use of staple-line reinforcement during laparoscopic gastric bypass.
8297304 - Laparoscopically assisted anterior resection for villous adenoma of the rectum.
4017824 - Sphincter-saving procedure for treatment of diffuse cavernous hemangioma of the rectum ...
2393814 - Fistulotomy without external sphincter division for high anal fistulae.
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2007-12-13
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  51     ISSN:  0012-3706     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-01-14     Completed Date:  2008-04-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  109-15     Citation Subset:  IM    
Affiliation:
Department of Colorectal Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qinchun Road, Hangzhou, China. yefengcnzjhz@hotmail.com
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Anastomosis, Surgical / instrumentation*
Biocompatible Materials
Female
Humans
Ileostomy
Male
Middle Aged
Postoperative Complications / prevention & control
Prostheses and Implants*
Rectal Neoplasms / surgery*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Biocompatible Materials

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Clinical, manometric, and ultrasonographic results of pneumatic balloon dilatation vs. lateral inter...
Next Document:  Production and bioactivity of common lichen metabolites as exemplified by Heterodea muelleri (Hampe)...