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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...

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Autores principales: Kryzauskas, Marius, Jakubauskas, Matas, Gendvilaite, Neda, Rudaitis, Vilius, Poskus, Tomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
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.
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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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