Risk factors for stoma outlet obstruction : preventing this complication after construction of diverting ileostomy during laparoscopic colorectal surgery

• 資料種別: 記事
• タイトル: Risk factors for stoma outlet obstruction : preventing this complication after construction of diverting ileostomy during laparoscopic colorectal surgery
• 著者・編者: Kiyomitsu Kuwahara; Yasuji Mokuno; Hideo Matsubara; Masahito Uji; Ichiro Kobayashi; Shinsuke Iyomasa
• 出版事項: 日本 : Japan Medical Association
• 出版年月日等: 2022-04-15
• 出版年（W3CDTF）: 2022-04-15
• タイトル（掲載誌）: JMA Journal
• 巻号年月日等（掲載誌）: 5(2)
• 掲載巻: 5(2)
• ISSN（掲載誌）: 2433-3298
• ISSN-L（掲載誌）: 2433-328X
• 本文の言語コード: eng
• DOI: 10.31662/jmaj.2021-0187; https://doi.org/10.31662/jmaj.2021-0187
• 国立国会図書館永続的識別子: info:ndljp/pid/14494908; https://dl.ndl.go.jp/pid/14494908
• コレクション（共通）: 障害者向け資料
• コレクション（障害者向け資料：レベル1）: テキストデータ
• コレクション（個別）: 国立国会図書館デジタルコレクション > 電子書籍・電子雑誌 > その他; https://dl.ndl.go.jp/collections/B00035
• 収集根拠: インターネット資料収集保存事業（WARP）
• 受理日（W3CDTF）: 2025-10-21T09:04:40+09:00
• 保存日（W3CDTF）: 2024-09-26
• 記録形式（IMT）: application/pdf
• オンライン閲覧公開範囲: インターネット公開
• 遠隔複写可否（NDL）: 不可
• 掲載誌（URI）: https://warp.da.ndl.go.jp/info:ndljp/pid/13747952/www.jmaj.jp/detail.php?id=10.31662%2Fjmaj.2021-0187
• 掲載誌（国立国会図書館永続的識別子）: info:ndljp/pid/14494903; https://dl.ndl.go.jp/pid/14494903
• 連携機関・データベース: 国立国会図書館 : 国立国会図書館デジタルコレクション; https://dl.ndl.go.jp

• 要約等: <p><b>Introduction</b>: Bowel obstruction at the outlet of the stoma, also referred to as "stoma outlet obstruction" (SOO), has been noted to be more common after laparoscopic colorectal surgery with diverting ileostomy than after laparotomy. Thus, the aim of this study is to identify the risk factors for SOO and to evaluate the effectiveness of a modified ileostomy procedure for reducing its incidence.</p><p><b>Methods</b>: The medical records of 63 patients who underwent laparoscopic colorectal surgery with diverting ileostomy between January 2014 and July 2021 were retrospectively reviewed. We analyzed the risk factors for SOO using computed tomography findings.</p><p><b>Results</b>: In total, 34 patients underwent surgery before modification of the ileostomy procedure (LSa group), and 29 patients underwent surgery after modification (LSb group). In the LSa group, 6 patients have reportedly developed SOO (SOO group), whereas 28 patients did not (non-SOO group). No patients in the LSb group developed SOO. The thickness of the abdominal rectus muscle (ThM) in the SOO group and the non-SOO group was 13.4 mm and 9.6 mm, respectively (<i>p</i> = 0.005). The angle between the ileostomy and the abdominal wall (AIW) was 95.8° in the non-SOO group and 82.2° in the SOO group (<i>p</i> = 0.033). The AIW was 93.4° in the LSa group and 99.7° in the LSb group (<i>p</i> = 0.043).</p><p><b>Conclusions</b>: As per our findings, a thick abdominal rectus muscle is predictive of SOO. Correction of the AIW (eliminating medial inclination) by modifying the operative technique has eliminated the occurrence of SOO in our patient population.</p>
• DOI: 10.31662/jmaj.2021-0187
• オンライン閲覧公開範囲: インターネット公開
• 連携機関・データベース: 科学技術振興機構 : J-STAGE; http://www.jstage.jst.go.jp

• 要約等: <p><b>Introduction</b>: Bowel obstruction at the outlet of the stoma, also referred to as "stoma outlet obstruction" (SOO), has been noted to be more common after laparoscopic colorectal surgery with diverting ileostomy than after laparotomy. Thus, the aim of this study is to identify the risk factors for SOO and to evaluate the effectiveness of a modified ileostomy procedure for reducing its incidence.</p><p><b>Methods</b>: The medical records of 63 patients who underwent laparoscopic colorectal surgery with diverting ileostomy between January 2014 and July 2021 were retrospectively reviewed. We analyzed the risk factors for SOO using computed tomography findings.</p><p><b>Results</b>: In total, 34 patients underwent surgery before modification of the ileostomy procedure (LSa group), and 29 patients underwent surgery after modification (LSb group). In the LSa group, 6 patients have reportedly developed SOO (SOO group), whereas 28 patients did not (non-SOO group). No patients in the LSb group developed SOO. The thickness of the abdominal rectus muscle (ThM) in the SOO group and the non-SOO group was 13.4 mm and 9.6 mm, respectively (<i>p</i> = 0.005). The angle between the ileostomy and the abdominal wall (AIW) was 95.8° in the non-SOO group and 82.2° in the SOO group (<i>p</i> = 0.033). The AIW was 93.4° in the LSa group and 99.7° in the LSb group (<i>p</i> = 0.043).</p><p><b>Conclusions</b>: As per our findings, a thick abdominal rectus muscle is predictive of SOO. Correction of the AIW (eliminating medial inclination) by modifying the operative technique has eliminated the occurrence of SOO in our patient population.</p>
• DOI: 10.31662/jmaj.2021-0187; https://doi.org/10.31662/jmaj.2021-0187
• 関連情報（URI）: http://id.ndl.go.jp/digimeta/14494908; https://dl.ndl.go.jp/pid/14494908; https://www.jmaj.jp/download.php?id=10.31662/jmaj.2021-0187; https://search.jamas.or.jp/link/ui/2023214165
• 参照: Risk Factors for Stoma Outlet Obstruction after Proctocolectomy for Ulcerative Colitis; https://cir.nii.ac.jp/crid/1390298919731050880; 一時的回腸双孔式人工肛門におけるストマ出口症候群のリスク因子の検討; https://cir.nii.ac.jp/crid/1390862179308880640; Risk Assessment of Stoma Outlet Obstruction Development when a Temporary Ileostomy is Created during Rectal Cancer Surgery; https://cir.nii.ac.jp/crid/1390866912695596416
• 連携機関・データベース: 国立情報学研究所 : CiNii Research; https://cir.nii.ac.jp/
• 提供元機関・データベース: Japan Link Center; https://japanlinkcenter.org/top; 雑誌記事索引データベース; https://ndlsearch.ndl.go.jp; Crossref; https://www.crossref.org
• 書誌ID（NDLBibID）: 14494908; http://id.ndl.go.jp/bib/14494908