Objective: The aim of this study was to determine the feasibility and safety of the skin bridge loop technique for colostomy and ileostomy in a gynecological oncology unit. Design: The study's design is a prospective observational case series of skin bridge loop stoma formation. Materials and Methods: All patients in a gynecologic oncology unit requiring defunctioning ileostomy or colostomy as an independent surgical procedure from October 2010 to February 2012 were included in this study. The setting was a tertiary referral center for gynecological oncology and minimal access surgery in Dublin, Ireland. The skin bridge loop enteric and colonic stoma formation technique involves carving a permanent skin bridge within the stoma site. The skin bridge is then fashioned under the loop and tensioned to the required level of elevation. Results: No stomal complications arose in this series of 16 patients in follow-up to 73 weeks. Stomal education was commenced from the first postoperative day, and self-care was achieved in a median of 5 days. Conclusions: The skin bridge stoma is easy to fashion and facilitates early patient self-care education, progression to other treatment, and/or discharge from hospital. We recommend its application in gynecologic oncology. (J GYNECOL SURG 29:47)
Get full access to this article
View all access options for this article.
References
1.
DvoretskyPM, RichardsKA, AngelAet al.Survival time, causes of death and tumor/treatment morbidity in 100 women with ovarian cancer. Hum Pathol, 1988; 19:1273.
2.
PothuriB, VaidyaA, AghajanianC, VenkatramanE, BarakatRR, ChiDS. Palliative surgery for bowel obstruction in recurrent ovarian cancer: an updated series. Gynecol Oncol, 2003; 89:306.
3.
KrebsHB, GoplerudDR. Mechanical intestinal obstruction in patients with gynecological disease, a review of 368 patients. Am J Obstet Gynecol, 1987; 157:577.
ChiDS, PhaetonR, MinerTJet al.A prospective outcomes analysis of palliative procedures performed for malignant intestinal obstruction due to recurrent ovarian cancer. The Oncologist, 2009; 14:835.
6.
HoffmanMS, GleesonNC, FinanMAet al.Palliative intestinal surgery for patients with carcinoma of the cervix. J Gynecol Surg, 1994; 10:63.
7.
HallfeldtK, SchmidbauerS, TrupkaA. Laparoscopic loop colostomy for advanced ovarian cancer, rectal cancer and rectovaginal fistulas. Gynecol Oncol, 2000; 76:380.
8.
SegretiEM, LevenbackC, MorrisM, LucasK, GershensonDM, BurkerTW. A comparison of end and loop colostomy for fecal diversion in gynecologic patients with colonic fistulas. Gynecol Oncol, 1996; 60:49.
9.
RickettJW. Subcutaneous colostomy rod. Br Med J, 1969; 3:466.
10.
Alexander-WilliamsJ. Loop ileostomy and colostomy for faecal diversion. Ann R Coll Surg Engl, 1974; 54:141.
11.
PotichaSM. A new technique for loop colostomy with use of plastic bridge. Am J Surg, 1974; 12:620.
12.
ArumugamPJ, BevanL, MacdonaldLet al.A prospective audit of stomas—analysis of risk factors and complications and their management. Colorectal Dis, 2003; 5:49.
13.
JarpaS. Transverse or sigmoid loop colostomy fixed by skin flaps. Surg Gynecol Obstet, 1986; 163:372.
14.
RubinSC, HoskinsWJ, BenjaminIet al.Palliative surgery for intestinal obstruction in advanced ovarian cancer. Gynecol Oncol, 1989; 34:16.
15.
JongP, SturgeonJ, JamiesonCG. Benefit of palliative surgery for bowel obstruction in advanced ovarian cancer. Can J Surgery, 1995; 38:454.
16.
HoffmanMS, BartonDP, GatesJet al.Complications of colostomy performed on gynecologic cancer patients. Gynecol Oncol, 1992; 44:231.
