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Rod in loop ileostomy: just an insignificant detail for ileostomy-related complications?

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Abstract

Background and aims

The aim of this prospective study was to validate a variant in the loop ileostomy construction to reduce peristomal pressure ulcers and, subsequently, the need of stoma therapist assistance and the frequency of changing the stoma appliance.

Patients and methods

We have enrolled 33 consecutive patients who underwent two stage restorative proctocolectomies. The first consecutive 13 patients operated on had their ileostomies constructed with a standard rod. In the following 20 patients, we placed a 5.3-mm suction catheter tube closed with a stitch to form a “ring” and without any stitches fixing it to the skin.

Results

In the “ring” rod group 40% of patients did not report any complication compared to the 8% of patients in the standard rod group (p = 0.046). Pressure ulcers were absent in this group, while it affected 61% of the patients in the standard rod group (p < 0.001). Patients in the “ring” rod group needed significantly less assistance time by the stoma therapist (p < 0.01) and required significantly fewer stoma appliance changes (p < 0.01). In our institution, the overall cost for the complete management of a standard rod ileostomy was 73.16 (29.83–130.49) euro compared to 46.65 (23.15–93.48) euro for a “ring” rod ileostomy (p = 0.002).

Conclusions

The adoption of a “ring” rod configuration led to an elimination of pressure ulcers due to the rigid rod, a shorter time requirement for stoma care and a decreased number of appliances required and was subsequently associated with lower costs of assistance. A tighter fitting around the ileostomy that avoided stool infiltration improved the practical management of the stoma with a “ring” rod.

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Acknowledgements

We are very grateful to Joanne Stempak, Research Coordinator at the Mount Sinai Hospital of Toronto, Canada, for her competent and careful revision of the English article. We are also very grateful to Dr. Paul J. van Koperen, Academic Medical Centre of Amsterdam, for his careful paper revision and his suggestions.

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Authors and Affiliations

  1. Department of Surgical and Gastroenterological Science, Sezione di Clinica Chirurgica I, University of Padova, Padova, Italy

    Marco Scarpa, Laura Sadocchi, Cesare Ruffolo, Teresa Filosa, Daniela Prando, Lino Polese, Mauro Frego, Davide F. D’Amico & Imerio Angriman

  2. Department of Surgical and Gastroenterological Sciences, Sezione di Endocrinochirurgia, University of Padova, Padova, Italy

    Maurizio Iacobone

  3. Azienda Ospedaliera di Padova, Dipartimento di Scienze Chirurgiche e Gastroenterologiche, Sez. Clinica Chirurgica I, Università di Padova, Via Giustiniani 2, 35128, Padova, Italy

    Marco Scarpa

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  1. Marco Scarpa
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  2. Laura Sadocchi
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  3. Cesare Ruffolo
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  4. Maurizio Iacobone
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  5. Teresa Filosa
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  6. Daniela Prando
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  7. Lino Polese
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  8. Mauro Frego
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  9. Davide F. D’Amico
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  10. Imerio Angriman
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Correspondence to Marco Scarpa.

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Scarpa, M., Sadocchi, L., Ruffolo, C. et al. Rod in loop ileostomy: just an insignificant detail for ileostomy-related complications?. Langenbecks Arch Surg 392, 149–154 (2007). https://doi.org/10.1007/s00423-006-0105-x

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  • DOI: https://doi.org/10.1007/s00423-006-0105-x

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