Is the routine use of a water-soluble contrast enema prior to closure of a loop ileostomy necessary? A review of a single institution experience.
AuthorDimitriou, N; Panteleimonitis, S; Dhillon, A; Boyle, K; Norwood, M; Hemingway, D; Yeung, J; Miller, A
Source TitleWorld Journal of Surgical Oncology
PublisherSpringer Science and Business Media LLC
University of Melbourne Author/sYeung, Justin
AffiliationSurgery (Western Health)
Document TypeJournal Article
CitationsDimitriou, N., Panteleimonitis, S., Dhillon, A., Boyle, K., Norwood, M., Hemingway, D., Yeung, J. & Miller, A. (2015). Is the routine use of a water-soluble contrast enema prior to closure of a loop ileostomy necessary? A review of a single institution experience.. World J Surg Oncol, 13 (1), pp.331-. https://doi.org/10.1186/s12957-015-0742-z.
Access StatusOpen Access
Open Access at PMChttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC4670542
BACKGROUND: The aims of the study were to determine the radiological leak rate in those patients who had undergone a resection for left-sided colorectal cancer and to see if the presence of a leak can be related with the postoperative clinical period. We also aimed to identify any common factors between patients with leak. METHODS: A retrospective analysis of prospectively collected data of all patients who underwent a left-sided colorectal cancer resection with formation of a defunctioning ileostomy was undertaken. Between 2005 and 2010, 418 such patients were identified. RESULTS: A water-soluble contrast enema was performed in 339 patients (81.1 %). Of these, 24 (7.1 %) were reported to show an anastomotic leak. Data for these 24 patients is presented in this study. Twenty-three (95.8 %) of the leaks occurred in patients who had undergone an anterior resection; 95.8 % of the patients with a leak were male. Fifteen (62.5 %) patients underwent neo-adjuvant radiation. The mean length of stay in those patients shown to have a subsequent radiological leak was 18.8 days (median), compared with the overall unit figures of 12 days. Only 29.2 % of the patients who had a leak identified had an uncomplicated postoperative period. Overall 87.5 % of the patients had a reversal of the ileostomy. CONCLUSIONS: Radiological leakage is not uncommon. The majority of patients, who were shown to have a radiological leak in this study, were male, had undergone an anterior resection, had received neo-adjuvant radiation, had a longer initial length of stay and had postoperative complications. Water-soluble contrast enemas could be selectively used in patients with these characteristics.
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