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Bowel Rest with Total Parenteral Nutrition as an Alternative to Diverting Ileostomy in High-Risk Colorectal Anastomosis: A Pilot Study
Anastomotic leakage remains the most feared complication in colorectal surgery. Various intraoperative tests evaluate bowel perfusion and mechanical integrity of the colorectal anastomosis. These tests reduce the risk of postoperative anastomotic leakage; however, the incidence remains high. Diverti...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9025484/ https://www.ncbi.nlm.nih.gov/pubmed/35454349 http://dx.doi.org/10.3390/medicina58040510 |
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author | Kryzauskas, Marius Jakubauskas, Matas Gendvilaite, Neda Rudaitis, Vilius Poskus, Tomas |
author_facet | Kryzauskas, Marius Jakubauskas, Matas Gendvilaite, Neda Rudaitis, Vilius Poskus, Tomas |
author_sort | Kryzauskas, Marius |
collection | PubMed |
description | Anastomotic leakage remains the most feared complication in colorectal surgery. Various intraoperative tests evaluate bowel perfusion and mechanical integrity of the colorectal anastomosis. These tests reduce the risk of postoperative anastomotic leakage; however, the incidence remains high. Diverting loop ileostomy mitigates the damage if anastomotic leakage occurs. Nevertheless, ileostomy has a significant rate of complications, reducing patients’ quality of life, and requiring an additional operation. We evaluated six consecutive cases where bowel rest with total parenteral nutrition was used instead of diverting loop ileostomy. All colorectal anastomoses were at high risk of postoperative anastomotic leakage. Total parenteral nutrition was administered for the first seven days postoperatively. There were no serious complications during the recovery period, and no clinical postoperative anastomotic leakage was detected. All patients tolerated total parenteral nutrition. Bowel rest with total parenteral nutrition may be a feasible option in high-risk left-sided colorectal anastomosis and a possible alternative to a preventive loop ileostomy. Further studies are necessary to evaluate it on a larger scale. |
format | Online Article Text |
id | pubmed-9025484 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-90254842022-04-23 Bowel Rest with Total Parenteral Nutrition as an Alternative to Diverting Ileostomy in High-Risk Colorectal Anastomosis: A Pilot Study Kryzauskas, Marius Jakubauskas, Matas Gendvilaite, Neda Rudaitis, Vilius Poskus, Tomas Medicina (Kaunas) Brief Report Anastomotic leakage remains the most feared complication in colorectal surgery. Various intraoperative tests evaluate bowel perfusion and mechanical integrity of the colorectal anastomosis. These tests reduce the risk of postoperative anastomotic leakage; however, the incidence remains high. Diverting loop ileostomy mitigates the damage if anastomotic leakage occurs. Nevertheless, ileostomy has a significant rate of complications, reducing patients’ quality of life, and requiring an additional operation. We evaluated six consecutive cases where bowel rest with total parenteral nutrition was used instead of diverting loop ileostomy. All colorectal anastomoses were at high risk of postoperative anastomotic leakage. Total parenteral nutrition was administered for the first seven days postoperatively. There were no serious complications during the recovery period, and no clinical postoperative anastomotic leakage was detected. All patients tolerated total parenteral nutrition. Bowel rest with total parenteral nutrition may be a feasible option in high-risk left-sided colorectal anastomosis and a possible alternative to a preventive loop ileostomy. Further studies are necessary to evaluate it on a larger scale. MDPI 2022-04-02 /pmc/articles/PMC9025484/ /pubmed/35454349 http://dx.doi.org/10.3390/medicina58040510 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Brief Report Kryzauskas, Marius Jakubauskas, Matas Gendvilaite, Neda Rudaitis, Vilius Poskus, Tomas Bowel Rest with Total Parenteral Nutrition as an Alternative to Diverting Ileostomy in High-Risk Colorectal Anastomosis: A Pilot Study |
title | Bowel Rest with Total Parenteral Nutrition as an Alternative to Diverting Ileostomy in High-Risk Colorectal Anastomosis: A Pilot Study |
title_full | Bowel Rest with Total Parenteral Nutrition as an Alternative to Diverting Ileostomy in High-Risk Colorectal Anastomosis: A Pilot Study |
title_fullStr | Bowel Rest with Total Parenteral Nutrition as an Alternative to Diverting Ileostomy in High-Risk Colorectal Anastomosis: A Pilot Study |
title_full_unstemmed | Bowel Rest with Total Parenteral Nutrition as an Alternative to Diverting Ileostomy in High-Risk Colorectal Anastomosis: A Pilot Study |
title_short | Bowel Rest with Total Parenteral Nutrition as an Alternative to Diverting Ileostomy in High-Risk Colorectal Anastomosis: A Pilot Study |
title_sort | bowel rest with total parenteral nutrition as an alternative to diverting ileostomy in high-risk colorectal anastomosis: a pilot study |
topic | Brief Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9025484/ https://www.ncbi.nlm.nih.gov/pubmed/35454349 http://dx.doi.org/10.3390/medicina58040510 |
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