A novel technique for superficial complicated stomas using the Dacron vascular prosthesis.

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Tytuł:: A novel technique for superficial complicated stomas using the Dacron vascular prosthesis.
Autorzy:: Féres O; Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, 14048-900, Brazil.
da Rocha JJR; Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, 14048-900, Brazil.
Feitosa MR; Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, 14048-900, Brazil.
Parra RS; Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, 14048-900, Brazil. .
Źródło:: Langenbeck's archives of surgery [Langenbecks Arch Surg] 2021 Jun; Vol. 406 (4), pp. 1239-1244. Date of Electronic Publication: 2021 May 14.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Original Publication: Berlin : Springer-Verlag, c1998-
MeSH Terms:: Enterostomy*
Surgical Stomas*/adverse effects
Blood Vessel Prosthesis ; Humans ; Polyethylene Terephthalates ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology
References:: Gilshtein H, Ghuman A, Dawoud M et al (2020) Indications for, and outcomes of, end ileostomy revision procedures. Colorectal Dis. https://doi.org/10.1111/codi.15449.
Tsujinaka S, Tan KY, Miyakura Y et al (2020) Current management of intestinal stomas and their complications. J Anus Rectum Colon 4(1):25–33. https://doi.org/10.23922/jarc.2019-032. (PMID: 10.23922/jarc.2019-032320024736989127)
Kwiatt M, Kawata M (2013) Avoidance and management of stomal complications. Clin Colon Rectal Surg. 26(2):112–121. https://doi.org/10.1055/s-0033-1348050. (PMID: 10.1055/s-0033-1348050244366593709920)
Stelton S (2019) CE: Stoma and peristomal skin care: a clinical review. Am J Nurs. 119(6):38–45. https://doi.org/10.1097/01.NAJ.0000559781.86311.64. (PMID: 10.1097/01.NAJ.0000559781.86311.6431135430)
Steinhagen E, Colwell J, Cannon LM (2017) Intestinal stomas-postoperative stoma care and peristomal skin complications. Clin Colon Rectal Surg. 30(3):184–192. https://doi.org/10.1055/s-0037-1598159. (PMID: 10.1055/s-0037-1598159286849365498169)
Nagano M, Ogata Y, Ikeda M, Tsukada K, Tokunaga K, Iida S (2019) Peristomal moisture-associated skin damage and independence in pouching system changes in persons with new fecal ostomies. J Wound Ostomy Continence Nurs. 46(2):137–142. https://doi.org/10.1097/WON.0000000000000491. (PMID: 10.1097/WON.0000000000000491306888646519776)
Krishnamurty DM, Blatnik J, Mutch M (2017) Stoma Complications. Clin Colon Rectal Surg. 30(3):193–200. https://doi.org/10.1055/s-0037-1598160. (PMID: 10.1055/s-0037-1598160286849375498161)
Miyo M, Takemasa I, Ikeda M, Tujie M, Hasegawa J, Ohue M, Kato T, Mizushima T, Doki Y, Mori M (2017) The influence of specific technical maneuvers utilized in the creation of diverting loop-ileostomies on stoma-related morbidity. Surg Today. 47(8):940–950. https://doi.org/10.1007/s00595-017-1481-2. (PMID: 10.1007/s00595-017-1481-228280983)
Rivet EB (2019) Ostomy management: a model of interdisciplinary care. Surg Clin North Am. 99(5):885–898. https://doi.org/10.1016/j.suc.2019.06.007. (PMID: 10.1016/j.suc.2019.06.00731446916)
de Donato G, Setacci F, Galzerano G, Ruzzi U, Borrelli MP, Mazzitelli G, Setacci C (2014) Prosthesis infection: prevention and treatment. J Cardiovasc Surg (Torino). 55(6):779–792.
Féres O, Feitosa MR, Parra RS, da Rocha JJR (2020) Dacron vascular prosthesis for superficially complicated stomas. Tech Coloproctol. https://doi.org/10.1007/s10151-020-02344-0.
Contributed Indexing:: Keywords: Intraoperative complication; Peritoneal stomata; Postoperative complication; Prosthesis and implant; Surgical stoma
Substance Nomenclature:: 0 (Polyethylene Terephthalates)
Entry Date(s):: Date Created: 20210514 Date Completed: 20210924 Latest Revision: 20210924
Update Code:: 20240105
DOI:: 10.1007/s00423-021-02194-w
PMID:: 33988745
: Czasopismo naukowe

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Background and Purpose: Despite the advances achieved in surgical techniques in recent years, an intestinal stoma is still needed in many patients undergoing colorectal surgery. However, the intestinal stoma may be associated with serious complications and the need for a second surgical procedure. In extreme cases, when it is not possible to access the abdominal cavity, the management of a complicated stoma is challenging. The purpose of this study was to describe the use of a Dacron vascular prosthesis (DVP) in patients with intestinal stoma complications.
Methods: In patients with a shallow, superficial stoma or mucocutaneous separation (MCS), we sutured the prosthesis in the intestinal loop (at the edge of an intestinal fistula) to create a device to direct the fecal content to the collection bag.
Results: We included 9 patients in this series (colorectal cancer, n = 5; Crohn's disease, n = 2; giant abdominal hernia and morbid obesity, n = 2). The results obtained were promising since they showed good evolution in patients with severe intestinal complications and an impossibility of surgical correction of the stoma. Five patients presented complete healing, and two patients presented partial healing. There were two deaths caused by sepsis, which were not related to the surgical procedure. With this technique, there was a reduction in the leakage of intestinal contents into the peritoneal cavity and an increase in the healing of the peristomal dermatitis in most of the patients. The DVP could possibly represent a surgical alternative in selected patients with complicated stomas when surgical correction may not be a suitable option.
Conclusions: The authors recommend this technique for selected complex cases of stoma complications after unsuccessful attempts to adapt collecting equipment. The placement of the DVP allowed the peristomal skin to heal and improved the contamination of the peritoneal cavity.

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