Tomohiro Sonoda, Shinichiro Mori, Yoshiaki Kita, Kan Tanabe, Kenji Baba, Masayuki Yanagi, Yasuto Uchikado, Hiroshi Kurahara, Yuko Mataki, Masahiko Sakoda, Kosei Maemura, Shoji Natsugoe. Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University School of Medicine
OBJECTIVE: Laparoscopic ileostomy commonly performed for the patients with colorectal obstruction due to cancer, peritonitis with perforation of colon or the other reason. Reduced port surgery is a novel technique that may be performed when considering minimally invasive surgery and desiring a cosmetic benefit. The aim of this study was to evaluate safety and feasibility of reduced port laparoscopic ileostomy for the patients with advanced colorectal cancer before chemotherapy.
METHODS: Between July 2012 and August 2017, 39 patients who underwent reduced port laparoscopic ileostomy were included (15 male and 14 female, age: 66 years old. The outcomes were evaluated in terms of operation time, intraoperative blood loss and perioperative complications.
SUGICAL PROCEDURES: The patients were placed in the supine position and the operator stood left side. An access device with the wound-protector (EZ access, HAKKO, Nagono, Japan) was inserted on the future ileostomy site in the right lower abdomen, inserting two of 5-mm trocars, maintaining pneumoperitoneum at 10 mmHg with carbon dioxide. A 5-mm trocar was inserted in the left lower abdomen. A 5-mm flexible laparoscope was inserted from access device port. After exploring abdominal cavity, ileum end was identified. Then the marking using dye was put on the ileum of 25cm proximal from the ileum end. The ileum marked by dye was grasped, and extracted through the access devise. Then a Blooke ileostomy was created.
RESULTS: Reduced port laparoscopic ileostomy was performed for 39 patients with colorectal obstruction due to cancer before chemotherapy. The mean operative time was 107 minutes, the mean blood loss was 5.0 ml. Three patient received one additional port. There were no intraoperative complications. Five patients (12.8%) experienced postoperative complications (two of deep surgical site infection, one of pneumonia, one of outlet obstruction and one of renal dysfunction). There were no other intraoperative or postoperative complications.
CONCLUSION: Reduced port laparoscopic ileostomy is a safe and feasible procedure for the patients with advanced colorectal cancer before chemotherapy.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87636
Program Number: P233
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster