Scholarlink

Introduction <p>Anastomotic leakage (AL) is a serious complication after rectal cancer resection, often mitigated by diverting loop ileostomy. However, outlet obstruction remains a significant concern, potentially prolonging hospitalization and requiring reintervention. While surgical risk factors have been explored, patient-specific anatomical factors are less well understood. This study aimed to identify patient-related risk factors for outlet obstruction and evaluate a preventive surgical modification in high-risk patients undergoing laparoscopic and robotic rectal cancer surgeries.</p> Methods <p>This retrospective study included 318 patients who underwent laparoscopic or robotic rectal resection with a diverting loop ileostomy. Risk factors were assessed in a control cohort (April 2015–February 2020), followed by a modified ileostomy technique in a validation cohort (March 2020–December 2024).</p> Results <p>Increased rectus abdominis muscle thickness (TAM) and larger visceral fat area (AVF) were independent risk factors for outlet obstruction (<i>p</i> = 0.037 and <i>p</i> = 0.041, respectively). Patients with both factors had the highest incidence (52.6%). The modified technique significantly reduced obstruction among high-risk patients (<i>p</i> = 0.003) without increasing parastomal hernia rates.</p> Conclusions <p>TAM and AVF are independent predictors of outlet obstruction. A tailored fascial modification reduced obstruction in high-risk patients, supporting the value of preoperative anatomical assessment in surgical planning.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Patient-related risk factors for outlet obstruction in diverting loop ileostomy following minimally invasive rectal cancer surgery

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年12月24日

查看全文
  • M. Ishii,
  • A. Hamabe,
  • K. Okita,
  • T. Nishidate,
  • K. Okuya,
  • E. Akizuki,
  • A. Noda,
  • M. Miyo,
  • R. Miura,
  • M. Toyota,
  • K. Okamoto,
  • I. Takemasa

摘要

Introduction

Anastomotic leakage (AL) is a serious complication after rectal cancer resection, often mitigated by diverting loop ileostomy. However, outlet obstruction remains a significant concern, potentially prolonging hospitalization and requiring reintervention. While surgical risk factors have been explored, patient-specific anatomical factors are less well understood. This study aimed to identify patient-related risk factors for outlet obstruction and evaluate a preventive surgical modification in high-risk patients undergoing laparoscopic and robotic rectal cancer surgeries.

Methods

This retrospective study included 318 patients who underwent laparoscopic or robotic rectal resection with a diverting loop ileostomy. Risk factors were assessed in a control cohort (April 2015–February 2020), followed by a modified ileostomy technique in a validation cohort (March 2020–December 2024).

Results

Increased rectus abdominis muscle thickness (TAM) and larger visceral fat area (AVF) were independent risk factors for outlet obstruction (p = 0.037 and p = 0.041, respectively). Patients with both factors had the highest incidence (52.6%). The modified technique significantly reduced obstruction among high-risk patients (p = 0.003) without increasing parastomal hernia rates.

Conclusions

TAM and AVF are independent predictors of outlet obstruction. A tailored fascial modification reduced obstruction in high-risk patients, supporting the value of preoperative anatomical assessment in surgical planning.