Efficacy of a Cross Incision at the Rectal Muscle Fascia and Ileostomy Rotation for Prevention of Outlet Obstruction at the Ostomy Site in Restorative Proctocolectomy for Ulcerative Colitis

Abstract

The efficacy of a cross incision at the rectus muscle fascia and ileostomy rotation for outlet obstruction in restorative proctocolectomy with diverting loop ileostomy for ulcerative colitis was evaluated. Sixty patients with loop ileostomy were randomized into two groups: one with a cross incision at the rectus muscle fascia and the other with a lengthwise incision. The efficacy of ileostomy rotation was then subjected to ongoing study in 29 consecutive patients. The results demonstrate that a cross incision at the stoma tunnel and forced rotation of the mesentery cause disadvantages such as outlet obstruction and were associated with increased complications. We recommend lengthwise incision and simple rotation for diverting a loop ileostomy in restorative proctocolectomy.