Abstract
Objective : To clarify the risk factors for outlet obstruction after temporary ileostomy, as well as the relevance of outlet obstruction in laparoscopic surgery, exploring preventive measures.
Methods : The subjects were 51 patients with a temporary ileostomy constructed during rectal resection. They were divided into two groups based on the presence or absence of outlet obstruction (OO) : Group OO (5 patients) and Group Non-OO (46 patients). Patient background characteristics, thickness of the rectus abdominis muscle, and access to the digestive tract through the rectus abdominis muscle were retrospectively studied and compared between the two groups.
Results : All subjects in Group OO were males. The risk factors for OO were laparoscopic surgery (p=0.014) and a thick rectus abdominis muscle, especially during laparoscopic surgery, with the digestive tract penetrated near the center of the rectus abdominis muscle (p=0.010) or diagonally through the rectus abdominis muscle (p=0.041).
Conclusion : Outlet obstruction should be taken into consideration when constructing an ileostomy during laparoscopic surgery. As a preventive measure, lifting the intestinal tract vertically to the rectus abdominis muscle after release of the pneumoperitoneum is recommended.
