Impact of Temporary Protective Ileostomy on Intestinal Function and Quality of Life after a 2-Year Follow-up in Patients Who Underwent Colorectal Segmental Resection for Endometriosis

To compare 2-year follow-up intestinal function and quality of life (QoL) between women with temporary protective ileostomy (PI) and recanalization and women without PI after colorectal segmental resection for deep infiltrating endometriosis (DIE). Prospective observational exploratory study. Tertia...

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Bibliographic Details
Published in:	Journal of minimally invasive gynecology Vol. 27; no. 6; pp. 1324 - 1330
Main Authors:	Raimondo, Diego, Mattioli, Giulia, Degli Esposti, Eugenia, Gregori, Benedetta, Del Forno, Simona, Mastronardi, Manuela, Arena, Alessandro, Borghese, Giulia, Ambrosio, Marco, Seracchioli, Renato
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-09-2020
Subjects:	Adult Case-Control Studies Colonic Diseases - epidemiology Colonic Diseases - surgery Colorectal resection Deep infiltrating endometriosis Digestive System Surgical Procedures - adverse effects Endometriosis - epidemiology Endometriosis - surgery Female Follow-Up Studies Gastrointestinal Diseases - epidemiology Gastrointestinal Diseases - physiopathology Gastrointestinal Diseases - prevention & control Humans Ileostomy Ileostomy - adverse effects Ileostomy - methods Ileostomy - statistics & numerical data Intestines - physiology Intestines - physiopathology Laparoscopy Laparoscopy - adverse effects Postoperative Complications - epidemiology Postoperative Complications - etiology Postoperative Complications - prevention & control Prospective Studies Quality of Life Rectal Diseases - epidemiology Rectal Diseases - surgery Treatment Outcome Colorectal resection Deep infiltrating endometriosis Ileostomy Laparoscopy
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Summary:	To compare 2-year follow-up intestinal function and quality of life (QoL) between women with temporary protective ileostomy (PI) and recanalization and women without PI after colorectal segmental resection for deep infiltrating endometriosis (DIE). Prospective observational exploratory study. Tertiary level referral center for minimally invasive gynecologic surgery. Consecutive patients who underwent laparoscopic colorectal resection and PI because of DIE between January 2015 and January 2018; an equal number of women without PI were matched according to age and anamnestic findings to serve as controls. Realization of a PI or immediate recanalization in patients who underwent laparoscopic colorectal resection. Thirty-six patients were considered for the analyses: 18 in the PI group and 18 in the non-PI group. Baseline intestinal function and QoL were evaluated using 2 validated questionnaires. The main reasons for ileostomy were colpotomy (66.7%), ultralow bowel anastomosis (27.8%), concomitant ureteroneocystostomy, and positive Michelin test result (5.6%). The mean interval between first and second surgery in the PI group was 3.7 ± 1.7 months. Perioperative severe complications included 1 stenosis of colorectal anastomosis in 1 woman in the PI group and 1 perianastomotic abscess in the non-PI group; overall the complications were comparable between the 2 groups. At the 2-year follow-up from recanalization, bowel function and QoL improved from baseline, with no statistical differences between the groups (Knowles-Eccersley-Scott-Symptom delta: 5.9 ± 9.3 in the PI group vs 7.7 ± 10.2 in the non-PI group, p = .6; Gastrointestinal Quality of Life Index delta: 16.0 ± 27.5 vs 19.2 ± 24.7, p = .7). Temporary PI after colorectal resection for DIE does not seem to influence patients’ bowel function and QoL at a median follow-up from recanalization at 2 years.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Undefined-1 ObjectType-Feature-3 content type line 23
ISSN:	1553-4650 1553-4669
DOI:	10.1016/j.jmig.2019.10.017