Endoscopy-based early enterostomy closure

It is generally recommended that a temporary stoma be closed within 9-12 wk after its construction. However, because some patients poorly tolerate the temporary stoma owing to extracellular dehydration, difficult pouch fitting, parenteral nutrition requirement in cases when the stoma is very proximal, and psychological or social impact, it might be advisable to opt for early closure.

In order to assess the feasibility of early closure and its outcome, a research team from Japan endoscopically inspected blood flow and edema in the remnant bowel of stoma patients and defined a minimal delay as optimal for closing small bowel stomas. Their study was published on February 28, 2010 in the World Journal of Gastroenterology.

Fifteen patients who underwent massive bowel resection with enterostomy for superior mesenteric arterial occlusion (SMAO) were divided into a delayed closure group (D group) and an early closure group (E group). It was found that the mean duration from initial operation to enterostomy closure was significantly shorter in the E group (18.3 ± 2.1 d) than in the D group (34.3 ± 5.9 d). The duration of hospitalization after surgery was significantly shorter in the E group (33 ± 2.2 d) than in the D group (51 ± 8.9 d).

They concluded that endoscopic examination of blood flow and edema in the remnant bowel is a useful predictor to determine the time of enterostomy closure in SMAO cases.

Reference: Oida T, Kano H, Mimatsu K, Kawasaki A, Kuboi Y, Fukino N, Amano S. Endoscopy-based early enterostomy closure for superior mesenteric arterial occlusion. World J Gastroenterol 2010; 16(8): 992-996

http://www.wjgnet.com/1007-9327/16/992.asp

Correspondence to: Takatsugu Oida, MD, PhD, Department of Surgery, Social Insurance Yokohama Central Hospital, 268 Yamashita-cho, Naka-ku, Yokohama 231-8553, Japan. ooida.takatsugu@yokochu.jp

Telephone: +81-45-6411921 Fax: +81-45-6719872

World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H. pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2008 IF: 2.081. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.

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