Rectal cancer is one of the most common carcinomas worldwide. Prophylactic ostomy is widely applied to reduce the morbidity and mortality associated with anastomotic complications after proctectomy, especially for patients with low rectal carcinoma or neoadjuvant therapy. Both ileostomy and transverse colostomy are effective for faecal diversion, however, a loop ileostomy was associated with fewer parastomal complications and improved quality of life. A loop ileostomy is widely accepted due to its easy creation and closure.
The study aims to assess whether reinfusion of succus entericus prior to ileostomy closure can decrease the postoperative length of stay and ameliorate low anterior resection score.
This study is a retrospective analysis based on prospectively collected data. Patients were screened from May 2016 to November 2019. A total of 30 patients who underwent reinfusion with succus entericus (SER) were enrolled in the SER group and 42 patients without SER were enrolled in the non-SER group.
The Results of the study are:
There was no significant difference in the incidence of postoperative ileus between the succus entericus reinfusion (SER) group and the control group. Time to first passage of flatus or stool after surgery in the SER group (27.9 ± 6.02 h) is significantly shorter than the control group (32.3 ± 6.26, hours p = 0.004). Compared with the control group (5.52 (4.0–7.0) days), the postoperative length of stay in the SER group was 4.90 (3.0–7.0)days (p = 0.009). As for low anterior resection score(LARS), the SER group had a lower score 1 week after discharge than the control group (p = 0.034). However, 1 month after discharge, the LARS in the two groups had no significant difference.
Thus, the researchers concluded that self-administered succus entericus reinfusion is feasible prehabilitation management for outpatients and can improve better outcomes. Compared with the non-reinfusion group, the succus enterius reinfusion group displays significantly shorter time for gastrointestinal function recovery and postoperative hospital stay without increasing complication, and it can bring a better quality of life in a short term.
Reference:
Self-administered succus entericus reinfusion before ileostomy closure improves short-term outcomes by Zhen Liu, et al. published in the BMC Surgery.
https://bmcsurg.biomedcentral.com/articles/10.1186/s12893-021-01444-4
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