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Robotic low anterior resection with complete splenic flexure mobilization and defunctioning left-sided loop colostomy: a case series.

Martin RutegårdAnders GerdinJannice ForssellOlle SjöströmAndreas SöderströmPetrus Vinnars
Published in: Journal of surgical case reports (2024)
A defunctioning stoma is used to alleviate the consequences of anastomotic leakage after low anterior resection for rectal cancer. A loop ileostomy is often preferred but may lead to dehydration and kidney injury. Here, we present a case series for an alternative: the left-sided loop colostomy. A convenience sample of four patients underwent robotic low anterior resection for rectal cancer. A complete splenic flexure mobilization and a total mesorectal excision were performed. To defunction the anastomosis, the redundant left colon was brought up to a stoma site in the left iliac fossa and matured as a loop colostomy. Two patients experienced minor stoma leaks and one also had a small prolapse, while all patients had their colostomies reversed on average 7 months after surgery without complications. There were no dehydration episodes and creatinine levels remained within baseline levels at end of follow-up (on average 18 months).
Keyphrases
  • rectal cancer
  • end stage renal disease
  • ejection fraction
  • newly diagnosed
  • chronic kidney disease
  • peritoneal dialysis
  • prognostic factors
  • transcription factor
  • radiation therapy
  • risk factors
  • urinary incontinence