| Use of intracolonic bypass secured by a biodegradable anastomotic ring to protect the low rectal anastomosis. | |
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MedLine Citation:
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PMID: 18080714 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Feng Ye; Danyang Wang; Xiangming Xu; Fanlong Liu; Jianjiang Lin |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2007-12-13 |
Journal Detail:
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Title: Diseases of the colon and rectum Volume: 51 ISSN: 0012-3706 ISO Abbreviation: Dis. Colon Rectum Publication Date: 2008 Jan |
Date Detail:
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Created Date: 2008-01-14 Completed Date: 2008-04-10 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372764 Medline TA: Dis Colon Rectum Country: United States |
Other Details:
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Languages: eng Pagination: 109-15 Citation Subset: IM |
Affiliation:
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Department of Colorectal Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qinchun Road, Hangzhou, China. yefengcnzjhz@hotmail.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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0/Biocompatible Materials |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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