Loop Ileostomy and Colostomy—A Comparison between Supporting Plastic Rods and Epicutaneous or Subcutaneous Silicon Drains

DOI: 10.4236/ss.2011.25056   PDF   HTML     6,111 Downloads   11,167 Views   Citations


Purpose: Beside the conventional plastic rods, different techniques and materials have been proposed in the last years to prevent the loop from retraction into the abdominal cavity. The aim of this retrospective comparative study was to assess three different techniques of loop support. Methods: The study included 65 pa- tients who had loop ileostomy or colostomy formed. Depending on the decision of the operating surgeon, one of three techniques was chosen to fixate the stoma loop: an epicutaneous plastic rod (group 1, n = 14), an epicutaneous suture-fixated silicone drain (group 2, n = 27), or a subcutaneous silicone drain (group 3, n = 24). Results: The majority of patients (85%) received loop ileostomy. Pain intensity was significantly (p = 0.0014) different among the three groups. A total of 19 patients (30%) suffered a complication. There was a tendency towards less complications if the stoma was secured by a silicone drain with epicutaneous fixation. Comfort with stoma care was significantly different, with group 3 experiencing the best results. Conclusions: Using a subcutaneously tunnelled silicon drain as a stoma bridge results in less complications, less pain and higher satisfaction as compared to the conventional plastic rod. Conventional plastic rods should be avoided.

Share and Cite:

M. Langenbach, S. Sauerland, E. Issa, C. Nitschke and H. Zirngibl, "Loop Ileostomy and Colostomy—A Comparison between Supporting Plastic Rods and Epicutaneous or Subcutaneous Silicon Drains," Surgical Science, Vol. 2 No. 5, 2011, pp. 252-256. doi: 10.4236/ss.2011.25056.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] A. W. Gooszen, R. H. Geelkerken, J. Hermans, M. B. Lagaay and H. G. Gooszen, “Quality of Life with a Temporary Stoma: Ileostomy vs. Colostomy,” Diseases of the Colon & Rectum, Vol. 43, No. 5, 2000, pp. 650-655. doi:10.1007/BF02235581
[2] N. S. Williams, D. G. Nasmyth, D. Jones and A. H. Smith, “Defunctioning Stomas: A Prospective Controlled Trial Comparing Loop Ileostomy with Loop Transverse Colostomy,” British Journal of Surgery, Vol. 73, No. 7, 1986, pp. 566-570. doi:10.1002/bjs.1800730717
[3] S. D. Wexner, D. A. Taranow, O. B. Johansen, F. Itzkowitz, N. Daniel, J. J. Nogueras and D. G. Jagelman, “Loop Ileostomy is a Safe Option for Fecal Diversion,” Diseases of the Colon & Rectum, Vol. 36, No. 4, 1993, pp. 349-354. doi:10.1007/BF02053937
[4] J. Cottam, K. Richards, A. Hasted and A. Blackman, “Results of a Nationwide Prospective Audit of Stoma Complications within 3 Weeks of Surgery,” Colorectal Disease, Vol. 9, No. 9, 2007, pp. 834-838. doi:10.1111/j.1463-1318.2007.01213.x
[5] J. J. Park, A. Del Pino, C. P. Orsay, R. L. Nelson, R. K. Pearl, J. R. Cintron and H. Abcarian, “Stoma Complications: The Cook County Hospital Experience,” Diseases of the Colon & Rectum, Vol. 42, No. 12, 1999, pp. 1575 -1580. doi:10.1007/BF02236210
[6] S. M. Poticha, “A New Technic for Loop Colostomy with Use of a Plastic Bridge,” American Journal of Surgery, Vol. 127, No. 5, 1974, pp. 620-621. doi:10.1016/0002-9610(74)90333-X
[7] J. M. Corman and D. B. Odenheimer, “Securing the Loop—Historic Review of the Methods Used for Creating a Loop Colostomy,” Diseases of the Colon & Rectum, Vol. 34, No. 11, 1991, pp. 1014-1021. doi:10.1007/BF02049967
[8] P. M. Go, N. H. Vaessen, C. J. van Duin and J. Lens, “A Plastic Rod to Facilitate Longitudinal Incision of the Bowel. An Inexpensive and Practical Device,” Diseases of the Colon & Rectum, Vol. 29, No. 10, 1986, p. 674. doi:10.1007/BF02560338
[9] R. A. Cochrane, D. J. Hay and A. F. Jones, “A Better Bridge for Loop Stomas,” British Journal of Surgery, Vol. 83, No. 3, 1996, p. 365. doi:10.1002/bjs.1800830322
[10] R. J. Fitzgibbons, Jr., G. D. Schmitz and R. T. Bailey, Jr., “A Simple Technique for Constructing a Loop Enterostomy which Allows Immediate Placement of an Ostomy Appliance,” Surgery, gynecology & obstetrics, Vol. 164, No. 1, 1987, pp. 78-80.
[11] S. W. Atkinson and P. G. Bentley, “Subcutaneous Bridge Support for Defunctioning Loop Colostomy,” British Journal of Surgery, Vol. 83, No. 10, 1996, p. 1458. doi:10.1002/bjs.1800831042
[12] A. M. Branco and A. C. Saraiva, “Loop Colostomy with a Suprafascial Bridge Device,” Digestive Surgery, Vol. 26, 2009, No. 4, pp. 282-284.
[13] K. Harish, “The Loop Stoma Bridge—A New Technique,” Journal of Gastrointestinal Surgery, Vol. 12, No. 5, 2008, pp. 958-961. doi:10.1007/s11605-007-0413-7
[14] J. W. Nunoo-Mensah, A. Chatterjee, D. Khanwalkar and D. G. Nasmyth, “Loop Ileostomy: Modification of Technique,” Surgeon, Vol. 2, No. 5, 2004, pp. 287-291. doi:10.1016/S1479-666X(04)80099-4
[15] E. T. Goldstein and P. R. Williamson, “A More Functional Loop Ileostomy Rod,” Diseases of the Colon & Rectum, Vol. 36, No. 3, 1993, pp. 297-298. doi:10.1007/BF02053516
[16] G. Atkin, M. A. Scott, P. Mathur and I. C. Mitchell, “The Rectus Sling to Prevent Loop Colostomy Retraction: A Case Series,” International Seminars In Surgical Oncology, Vol. 2, 2005, p. 22. doi:10.1186/1477-7800-2-22
[17] M. Speirs, E. Leung, D. Hughes, I. Robertson, L. Donnelly, I. Mackenzie and A. Macdonald, “Ileostomy Rod —Is it a Bridge too Far?” Colorectal Disease, Vol. 8, No. 6, 2006, pp. 484-487. doi:10.1111/j.1463-1318.2005.00923.x
[18] J. A. Unti, H. Abcarian, R. K. Pearl, C. P. Orsay, R. L. Nelson, M. L. Prasad, B. Duarte, M. M. Leff and A. B. Tan, “Rodless Endloop Stomas. Seven-Year Experience,” Diseases of the Colon & Rectum, Vol. 34, No. 11, 1991, pp. 999-1004. doi:10.1007/BF02049964
[19] R. J. Aitken, P. J. Stevens, N. du Preez and M. S. Elliot, “Raising a Colostomy—Results of a Prospective Surgical Audit,” International Journal of Colorectal Disease, Vol. 1, No. 4, 1986, pp. 244-247. doi:10.1007/BF01648346
[20] P. J. Arumugam, L. Bevan, L. Macdonald, A. J. Watkins, A. R. Morgan, J. Beynon and N. D. Carr, “A Prospective Audit of Stomas—Analysis of Risk Factors and Complications and their Management,” Colorectal Disease, Vol. 5, No. 1, 2003, pp. 49-52. doi:10.1046/j.1463-1318.2003.00403.x
[21] D. A. Harris, D. Egbeare, S. Jones, H. Benjamin, A. Woodward and M. E. Foster, “Complications and Mortality Following Stoma Formation,” Annals of The Royal College of Surgeons of England, Vol. 87, No. 6, 2005, pp. 427-431. doi:10.1308/003588405X60713
[22] M. Caricato, F. Ausania, V. Ripetti, F. Bartolozzi, G. Campoli and R. Coppola, “Retrospective Analysis of Long-Term Defunctioning Stoma Complications after Colorectal Surgery,” Colorectal Disease, Vol. 9, No. 6, 2007, pp. 559-561. doi:10.1111/j.1463-1318.2006.01187.x
[23] I. Robertson, E. Leung, D. Hughes, M. Spiers, L. Donnelly, I. Mackenzie and A. Macdonald, “Prospective Analysis of Stoma-Related Complications,” Colorectal Disease, Vol. 7, No. 3, 2005, pp. 279-285. doi:10.1111/j.1463-1318.2005.00785.x
[24] M. Gutman, O. Kaplan, Y. Skornick, F. Greif, P. Kahn and R. R. Rozin, “Proximal Colostomy: Still an Effective Emergency Measure in Obstructing Carcinoma of the Large Bowel,” Journal of Surgical Oncology, Vol. 41, No. 3, 1989, pp. 210-212.
[25] J. C. Duchesne, Y. Z. Wang, S. L. Weintraub, M. Boyle and J. P. Hunt, “Stoma Complications: A Multivariate Analysis,” American Journal of Surgery, Vol. 68, No. 11, 2002, pp. 961-966.
[26] R. K. Pearl, M. L. Prasad, C. P. Orsay, H. Abcarian, A. B. Tan and M. T. Melzl, “Early Local Complications from Intestinal Stomas,” Archives of Surgery, Vol. 120, No. 10, 1985, pp. 1145-1147.
[27] L. R. Jenkinson, P. W. J. Houghton, K. V. Steele, L. A. Donaldson and M. K. H. Crumplin, “The Biethium Bridge—an Advance in Stoma Care,” Annals of The Royal College of Surgeons of England, Vol. 66, 1984, pp. 420-422.
[28] O. Kaidar-Person, B. Person and S. D. Wexner, “Complications of construction and closure of temporary loop ileostomy,” Journal of the American College of Surgeons, Vol. 201, No. 10, 2005, pp. 759-773. doi:10.1016/j.jamcollsurg.2005.06.002

comments powered by Disqus

Copyright © 2020 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.