ArticleTechniques in coloproctology2025
Patient-related risk factors for outlet obstruction in diverting loop ileostomy following minimally invasive rectal cancer surgery.
Article in Techniques in coloproctology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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- Metabolic syndrome: comparison of diagnostic capability among waist circumference and supine and upright multidetector computed tomography.Japanese journal of radiology · 2026Article
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Abstract
introductionAnastomotic 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.
methodsThis 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).
resultsIncreased 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.
conclusionsTAM 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.
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