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195031

Posterior Wall Colon Half Anastomosis for Fecal Diversion; a Pilot Prospective Study

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Last updated: 23 Jan 2023

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Abstract

Background: Colonic diversion is a common procedure in the practice of colo-rectal surgery; whether on emergent or elective basis. This “diversion", taking place after colon resection when primary anastomosis is “risky", takes one of two forms i.e divided or loop form. We introduced a modification for the double-barrel colostomy technique into a hand-sewn loop colostomy at the two divided ends achieving fecal diversion and at the same time assessing the healing power in the patient during the initial operation.
Patients and method: Fifty patients, candidate for fecal diversion after right colonic resection, having different risk factors for anastomotic leakage, were recruited. A posterior wall half colonic anastomosis was done between both resection ends before exteriorization in those patients instead of performing an ileostomy and a mucus fistula. 
Patients, then, completed their treatment plan for the primary pathology and their stomas were closed lately as “a loop" ileocolostomy without the need for re-laparotomy.
Results: All patients (with the except of one patient) had uneventful postoperative course following fecal diversion using the “hand-sewn loop" technique as regards bowl viability and fixation with all the patients being lately closed successfully without the need for re-laparotomy.
Conclusion: Performing a posterior wall half-anastomosis at the initial operation of fecal diversion is a feasible option for patients undergoing fecal diversion after partial colonic resection, helping to avoid morbidities encountered during the operation of restoration of bowl continuity while, simultaneously, testing for hidden risks for anastomotic leakage.

DOI

10.21608/asjs.2020.195031

Keywords

Fecal diversion, hand-sewn loop colostomy, colonic half anastomosis

Authors

First Name

Mohamed

Last Name

Hamed

MiddleName

KF

Affiliation

Department of General Surgery, Faculty of Medicine, Ain Shams University, Egypt

Email

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City

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Orcid

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First Name

Ahmed

Last Name

Sabry

MiddleName

M

Affiliation

Department of General Surgery, Faculty of Medicine, Ain Shams University, Egypt

Email

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City

-

Orcid

-

First Name

Amr

Last Name

Afifi

MiddleName

H

Affiliation

Department of General Surgery, Faculty of Medicine, Ain Shams University, Egypt

Email

dr_amrhamed1984@yahoo.com

City

-

Orcid

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Volume

13

Article Issue

2

Related Issue

27699

Issue Date

2020-07-01

Receive Date

2021-09-18

Publish Date

2020-07-01

Page Start

86

Page End

92

Print ISSN

2090-7249

Link

https://asjs.journals.ekb.eg/article_195031.html

Detail API

https://asjs.journals.ekb.eg/service?article_code=195031

Order

2

Type

Original Article

Type Code

1,943

Publication Type

Journal

Publication Title

Ain Shams Journal of Surgery

Publication Link

https://asjs.journals.ekb.eg/

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Article

Created At

23 Jan 2023