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Techniques in Coloproctology

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01-01-2020 | Enterostomy | Review

Virtual ileostomy in elective colorectal surgery: a systematic review of the literature

Authors: I. Baloyiannis, K. Perivoliotis, A. Diamantis, G. Tzovaras

Published in: Techniques in Coloproctology | Issue 1/2020

Abstract

Background

Anastomotic leak (AL) following colorectal surgery can be a life-threatening complication. The use of a diverting stoma has been proposed, to prevent or reduce morbidity and mortality associated with AL. Stomas, however, have their own distinct complications. Thus, virtual ileostomy (VI) has been proposed as an alternative to diverting stoma. The aim of the present study was to further evaluate the role of VI through systematic review of existing literature.

Methods

A systematic review of the literature was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Cochrane handbook for systematic reviews of interventions. The primary endpoint of our study was the estimation of the overall VI complication rate. Secondary endpoints included the identification of the VI-specific adverse outcomes, perioperative endpoints such as the length of hospital stay, transfusion and postoperative leak rates, description of the operative variations of VI reported VI operative variations and details regarding the primary operation and previous neoadjuvant therapy.

Results

In total, 11 studies and 554 patients were included in this systematic review. Overall, 158 laparoscopic and 191 open procedures were performed. The AL and VI conversion rates were 11.9% and 10.46%, respectively. The total complication rate was estimated to be 13.9%, while VI-specific adverse events were recorded in 2.1% of all cases.

Conclusions

VI could be a safe and effective alternative to a diverting stoma. Although currently, VI is not widely used, it could have a widespread application in laparoscopic surgery. However, definitive trials are needed before firm recommendations on the use of VI can be made.

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Title: Virtual ileostomy in elective colorectal surgery: a systematic review of the literature
Authors: I. Baloyiannis
K. Perivoliotis
A. Diamantis
G. Tzovaras
Publication date: 01-01-2020
Publisher: Springer International Publishing
Keywords: Enterostomy
Ileostomy
Enterostomy
Published in: Techniques in Coloproctology / Issue 1/2020
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI: https://doi.org/10.1007/s10151-019-02127-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Virtual ileostomy in elective colorectal surgery: a systematic review of the literature

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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