Skip to main content

Advertisement

SpringerLink
Log in

Is An Ostomy Rod Useful for Bridging the Retraction During the Creation of a Loop Ileostomy? A Randomized Control Trial

  • Original Scientific Report
  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

A loop ileostomy is generally created during restorative proctocolectomy (RPC) for treating ulcerative colitis (UC), and an ostomy rod is often used to prevent stoma retraction. However, its usefulness or harmfulness has not been proven. We performed a prospective randomized control study to investigate the non-inferiority of ostomy creation without a rod to prevent stoma retraction.

Methods

Patients with UC who underwent RPC were enrolled and randomly divided into groups either with or without ostomy rod use. Incidences of stoma retraction and dermatitis were compared.

Results

Of the 320 patients in the study groups, 308 qualified for the intention-to-treat (ITT) analysis, and 257 were included in the per-protocol (PP) analysis. Ostomy retraction was recognized in 6 patients, 3 with a rod and 3 without. The difference with rod use (95% confidence interval) was 0.1 (−2.9 to 3.1)% in the PP analysis and 0.0 (−2.2 to 2.2)% in the ITT analysis. There were no significant differences in stoma retraction regardless of whether an ostomy rod was used in either analysis. Dermatitis was more common in patients with rod use (84/154) than in those without (40/154) (p < 0.01).

Conclusions

Although median body mass indices were extremely low (20 kg/m2), an ostomy rod is not routinely needed as it may increase the risk of dermatitis. However, results in obese patients may differ from those shown here, which should be clarified via further studies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Tjandra JJ, Fazio VW, Milsom JW et al (1993) Omission of temporary diversion in restorative proctocolectomy—Is it safe? Dis Colon Rectum 36:1007–1014

    Article  CAS  PubMed  Google Scholar 

  2. Shellito PC (1998) Complications of abdominal stoma surgery. Dis Colon Rectum 41:1562–1572

    Article  CAS  PubMed  Google Scholar 

  3. McLeod RS, Lavery IC, Leatherman JR et al (1986) Factors affecting quality of life with a conventional ileostomy. World J Surg 10:474–480. doi:10.1007/BF01655313

    Article  CAS  PubMed  Google Scholar 

  4. Scarpa M, Angriman I, Ruffolo C et al (2004) Health-related quality of life after restorative proctocolectomy for ulcerative colitis: long-term results. World J Surg 28:124–129. doi:10.1007/s00268-003-7047-z

    Article  PubMed  Google Scholar 

  5. Scarpa M, Sadocchi L, Ruffolo C et al (2007) Rod in loop ileostomy: Just an insignificant detail for ileostomy-related complications? Langenbecks Arch Surg 392:149–154

    Article  PubMed  Google Scholar 

  6. Takesue Y, Takahashi Y, Ichiki K et al (2011) Application of an electrolyzed strongly acidic aqueous solution before wound closure in colorectal surgery. Dis Colon Rectum 54:826–832

    Article  PubMed  Google Scholar 

  7. Parks AG, Nicholls RJ (1978) Proctocolectomy without ileostomy for ulcerative colitis. Br Med J 2:85–88

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Ikeuchi H, Uchino M, Matsuoka H et al (2010) Surgery for ulcerative colitis in 1,000 patients. Int J Colorectal Dis 25:959–965

    Article  PubMed  Google Scholar 

  9. Truelove SC, Witts LJ (1955) Cortisone in ulcerative colitis; final report on a therapeutic trial. Br Med J 2:1041–1048

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Garner JS, Jarvis WR, Emori TG et al (1988) CDC definitions for nosocomial infections, 1988. Am J Infect Control 16:128–140

    Article  CAS  PubMed  Google Scholar 

  11. Uchino M, Ikeuchi H, Matsuoka H et al (2012) Clinical features and management of parastomal pyoderma gangrenosum in inflammatory bowel disease. Digestion 85:295–301

    Article  PubMed  Google Scholar 

  12. Leong AP, Londono-Schimmer EE, Phillips RK (1994) Life-table analysis of stomal complications following ileostomy. Br J Surg 81:727–729

    Article  CAS  PubMed  Google Scholar 

  13. Leenen LP, Kuypers JH (1989) Some factors influencing the outcome of stoma surgery. Dis Colon Rectum 32:500–504

    Article  CAS  PubMed  Google Scholar 

  14. Carlsen E, Bergan A (1995) Technical aspects and complications of end-ileostomies. World J Surg 19:632–636. doi:10.1007/BF00294742

    Article  CAS  PubMed  Google Scholar 

  15. Hebert JC (1988) A simple method for preventing retraction of an end colostomy. Dis Colon Rectum 31:328–329

    Article  CAS  PubMed  Google Scholar 

  16. Speirs M, Leung E, Hughes D et al (2006) Ileostomy rod—Is it a bridge too far? Colorectal Dis 8:484–487

    Article  CAS  PubMed  Google Scholar 

  17. Butler DL (2009) Early postoperative complications following ostomy surgery: a review. J Wound Ostomy Continence Nurs 36:513–519 quiz 520

    Article  PubMed  Google Scholar 

  18. Kann BR (2008) Early stomal complications. Clin Colon Rectal Surg 21:23–30

    Article  PubMed  PubMed Central  Google Scholar 

  19. Arumugam PJ, Bevan L, Macdonald L et al (2003) A prospective audit of stomas—analysis of risk factors and complications and their management. Colorectal Dis 5:49–52

    Article  CAS  PubMed  Google Scholar 

  20. Chaudhary P, Nabi I, Ranjan G et al (2015) Prospective analysis of indications and early complications of emergency temporary loop ileostomies for perforation peritonitis. Ann Gastroenterol 28:135–140

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Inflammatory Bowel Disease, Hyogo College of Medicine, Nishinomiya, Japan

    Motoi Uchino, Hiroki Ikeuchi, Toshihiro Bando, Teruhiro Chohno, Hirofumi Sasaki & Yuki Horio

Authors
  1. Motoi Uchino
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hiroki Ikeuchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Toshihiro Bando
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Teruhiro Chohno
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hirofumi Sasaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yuki Horio
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Motoi Uchino.

Ethics declarations

Conflict of interest

Authors have nothing to disclose.

Additional information

The study protocols have been registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR 00006658).

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Uchino, M., Ikeuchi, H., Bando, T. et al. Is An Ostomy Rod Useful for Bridging the Retraction During the Creation of a Loop Ileostomy? A Randomized Control Trial. World J Surg 41, 2128–2135 (2017). https://doi.org/10.1007/s00268-017-3978-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-017-3978-7

Keywords

Search

Navigation