A retrospective comparative analysis of two different techniques of small bowel diversion in Ileal perforation cases: a single centre experience

  • Dr Parijat Suryavanshi Assistant Professor, Department of General Surgery, KGMU, lucknow, UP, India
  • Dr Anurag rai Assistant Professor, Department of General Surgery, KGMU, lucknow, UP, India
  • Dr Abhishek suryavanshi Senior Consultant Surgeon, Akanksha Hospital, Barabanki, UP, India
  • Dr Rupali singh Consultant Gynaecologist, Akanksha Hospital, Barabanki, UP, India
Keywords: Ileostomy, Enteric, Perforation, Intestinal

Abstract

Introduction: Ileal perforation is a common surgical emergency especially in Indian sub-continent due to increased incidence of enteric fever and tuberculosis- two most common causes of ileal perforation. Many different techniques had been applied for treatment of perforation like primary closure, exteriorization of perforation site or primary closure with proximal diversion stoma. Many cases are not suitable for primary closure; in such cases ileostomy is done. Ileostomy is associated with significant morbidity which adds to financial burden and decreases quality of life. Tube ileostomy has been explored as an alternative to conventional ileostomy sans its morbidity.

Methods: Here we retrospectively analyzed ileal perforation cases treated with either loop ileostomy or tube ileostomy at our centre during last 3 years.

Result: A total of 50 ileal perforation cases treated with ileostomy either tube ileostomy ( n = 21) or conventional loop ileostomy (n = 29 ) were included for study and their immediate and late post operative complications were recorded and analysed.

Conclusion: We found that tube ileostomy is a safe and effective mode of diversion and is associated with minimal stoma related morbidity like peristomal excoriation, hernia, retraction, prolapse, obstruction etc.

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References

Turnbull RB, Jr., Weakley FL. Ileostomy technics and indications for surgery. Review of Surgery.1966;23(5):310–4.

Ahmed HN, Niaz MP, Amin MA, Khan MH, Parhar AB. Typhoid perforation still a common problem: situation in Pakistan in comparison to other countries of Low Human Development. Journal of the Pakistan Medical Association. 2006;56(5):230–2.

Singh KP, Singh K, Kohli JS. Choice of surgical procedure in typhoid perforation: experience in 42 cases.Journal of the Indian Medical Association. 1991;89(9):255–6.

Duchesne JC, Wang YZ, Weintraub SL, Boyle M, Hunt JP. Stoma complications: a multivariate analysis. Am Surg. 2002 Nov;68(11):961-6; discussion 966.

Mak GZ, Harberg FJ, Hiatt P, Deaton A, Calhoon R, Brandt ML. T-tube ileostomy for meconium ileus: four decades of experience. Journal of Pediatric Surgery. 2000;35(2):349–52.

Vijayraj Patil, Abhishek Vijayakumar, M. B. Ajitha, and Sharath Kumar L, “Comparison between Tube Ileostomy and Loop Ileostomy as a Diversion Procedure,” ISRN Surgery, vol. 2012, Article ID 547523, 5 pages, 2012. doi: https://doi.org/10.5402/2012/547523.

HUCKSTEP RL. Recent advances in the surgery of typhoid fever. Ann R Coll Surg Engl. 1960 Apr;26:207-30. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2413950/.

Bhansali SK. Gastrointestinal perforation: a clinical study of 96 cases. J Postgrad Med. 1967;13(1):1–12.

Talwar S, Sharma RK, Mittal DK, Prassad P. Typhoid enteric perforation. Aust N Z J Surg.1997;67(6):351–3.doi: https://doi.org/10.1111/j.1445-2197.1997.tb01990.x.

Rygl M, Pycha K, Stranak Z, et al. T-tube ileostomy for intestinal perforation in extremely low birth weight neonates. Pediatric Surgery International. 2007;23(7):685–688. DOI: https://doi.org/10.1007/s00383-007-1931-9.

Nachiappan S, Datta U, Askari A, Faiz O. Tube ileostomy for faecal diversion in elective distal colorectal anastomosis: a systematic review and pooled analysis. Colorectal Dis. 2015 ;17(8):665-73. DOI: https://doi.org/10.1111/codi.12997.

Wexner SD, Taranow DA, Johansen OB, et al. Loop ileostomy is a safe option for fecal diversion.Diseases of the Colon and Rectum. 1993;36(4):349–54.doi: https://doi.org/10.1007/bf02053937.

García-Botello SA, García-Armengol J, García-Granero E, et al. A prospective audit of the complications of loop ileostomy construction and takedown. Digestive Surgery. 2004;21(5-6):440–446. DOI: https://doi.org/10.1159/000083471.

A retrospective comparative analysis of two different techniques of small bowel diversion in Ileal perforation cases: a single centre experience
CITATION
DOI: 10.17511/ijmrr.2016.i12.11
Published: 2016-12-31
How to Cite
1.
Suryavanshi P, rai A, suryavanshi A, singh R. A retrospective comparative analysis of two different techniques of small bowel diversion in Ileal perforation cases: a single centre experience. Int J Med Res Rev [Internet]. 2016Dec.31 [cited 2021Jun.18];4(12):2142-6. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/781
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Original Article