Loop Transverse Colostomy - A Modified Technique

Author(s): Cheng Cai, Zhihui Dai, Zhifeng Zhong, Jianping Wang, Jinlin Du*

Journal Name: Combinatorial Chemistry & High Throughput Screening
Accelerated Technologies for Biotechnology, Bioassays, Medicinal Chemistry and Natural Products Research

Volume 21 , Issue 10 , 2018

Become EABM
Become Reviewer
Call for Editor


Background: Transverse colostomy is commonly performed to create temporary stoma in rectal cancer patients after neoadjuvant chemoradiotherapy. Conventional methods are either difficult to implement or to care for. To resolve these problems, we herein describe a modified transverse colostomy method.

Material and Methods: Two sutures of peritoneum were made as “bridges” to support the stoma. Absorbable sutures were utilized to reinforce the stoma. Once the stoma was created, the stoma bag was immediately placed on the skin. 120 patients who received conventional or modified transverse colostomy between 2008 and 2014 were selected. Then, the two groups of patients were compared for stoma-related complications.

Results: The operation time of stoma construction was 34±10 minutes for the conventional method and 28±7 minutes for the modified method (P= 0.009). There were no significant differences between the two groups with respect to postoperative bleeding, bowel obstruction or stoma retraction. Patients with conventional transverse colostomy were remarkably more likely to experience parastoma hernia (P= 0.048) and stoma prolapse (P= 0.038).

Conclusion: In comparison with conventional methods, the modified transverse colostomy is a safe and effective diverting technique. It can be readily performed by all kinds of surgeons, especially those in underdeveloped areas. The technique represents a preferred method for constructing temporary stoma in rectal cancer patients treated with neoadjuvant chemoradiotherapy.

Keywords: Colostomy, rectal cancer, chemoradiotherapy, neoadjuvant, temporary stoma, stoma-related complications.

Gastinger, I.; Marusch, F.; Steinert, R.; Wolff, S.; Koeckerling, F.; Lippert, H. Working Group ‘Colon/Rectum Carcinoma’. Protective defunctioning stoma in low anterior resection for rectal carcinoma. Br. J. Surg., 2005, 92(9), 1137-1142.
Gu, W.L.; Wu, S.W. Meta-analysis of defunctioning stoma in low anterior resection with total mesorectal excision for rectal cancer: Evidence based on thirteen studies. World J. Surg. Oncol., 2015, 13, 9.
Harish, K. The loop stoma bridge--a new technique. J. Gastrointest. Surg., 2008, 12(5), 958-961.
Matthiessen, P.; Hallböök, O.; Rutegård, J.; Simert, G.; Sjödahl, R. Defunctioning stoma reduces symptomatic anastomotic leakage after low anterior resection of the rectum for cancer: A randomized multicenter trial. Ann. Surg., 2007, 246(2), 207-214.
Edwards, D.P.; Leppington-Clarke, A.; Sexton, R.; Heald, R.J.; Moran, B.J. Stoma-related complications are more frequent after transverse colostomy than loop ileostomy: A prospective randomized clinical trial. Br. J. Surg., 2001, 88(3), 360-363.
Hua, H.; Xu, J.; Chen, W.; Zhou, X.; Wang, J.; Sheng, Q.; Lin, J. Defunctioning cannula ileostomy after lower anterior resection of rectal cancer. Dis. Colon Rectum, 2014, 57(11), 1267-1274.
Jenkinson, L.R.; Houghton, P.W.; Steele, K.V.; Donaldson, L.A.; Crumplin, M.K. The Biethium bridge--an advance in stoma care. Ann. R. Coll. Surg. Engl., 1984, 66(6), 420-422.
Atkin, G.; Scott, M.A.; Mathur, P.; Mitchell, I.C. The rectus sling to prevent loop colostomy retraction: A case series. Int. Semin. Surg. Oncol., 2005, 2, 22.
Nunoo-Mensah, J/W.; Chatterjee, A.; Khanwalkar, D.; Nasmyth, D.G. Loop ileostomy: Modification of technique. Surgeon, 2004, 2(5), 287-291.
Sudhindran, S.; Regunath, K.J. A better bridge for loop stomas. Br. J. Surg., 1996, 83(12), 1797.

Rights & PermissionsPrintExport Cite as

Article Details

Year: 2018
Page: [784 - 788]
Pages: 5
DOI: 10.2174/1386207322666181221161345
Price: $65

Article Metrics

PDF: 34