

32
Tania Gallart Aragón
Cierre precoz de ileostomía en cáncer de recto
y el coste sanitario del mismo. La reanudación precoz a las acti-
vidades de la vida diaria del paciente y la ausencia de estoma,
permiten una mejora notable en su calidad de vida (13,18,20).
CONCLUSIONES:
La realización de ileostomías de protección en las anasto-
mosis rectales bajas ha demostrado ser una medida preventiva
eficaz para disminuir la morbimortalidad de las dehiscencias de
las mismas. Su cierre no debe considerarse un procedimiento
menor. El cierre precoz de la ileostomía reduce el íleo postopera-
torio, la estancia media hospitalaria, mejora la calidad de vida y
el coste sanitario.
REFERENCIAS BIBLIOGRÁFICAS:
1.
Courtier R, Parés D, Silva CA, Gil MJ, Pascual M, Alonso S,
et al. Clinical results of loop ileostomy closures in rectal
cancer surgical patients. Effect of chemotherapy in the
waiting period. Cir Esp 2010; 88(5):308-13.
2.
Thalheimer A, Bueter M, Kortuem M, Thiede A, Meyer D.
Morbidity of temporary loop ileostomy in patients with
colorectal cancer. Dis Colon Rectum 2006;49(7):1011-7
3.
Wong KS, Remzi FH, Gorgun E, Arrigain S, Church JM,
Preen M, et al. Loop ileostomy closure after restorative
proctocolectomy: outcome in 1,504 patients. Dis Colon
Rectum 2005;48(2):243-50.
4.
Smedh K, Olsson L, Johansson H, Aberg C, Andersson M.
Reduction of postoperative morbidity and mortality in
patients with rectal cancer following the introduction of a
colorectal unit. Br J Surg 2001; 88(2):273-7.
5.
Peeters KC, Tollenaar RA, Marijnen CA, Klein Kranenbarg E,
Steup WH, Wiggers T, et al. Dutch Colorectal Cancer Group.
Risk factors for anastomotic failure after total mesorectal
excision of rectal cancer. Br J Surg 2005;92(2):211-6
6.
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):1137-42
7.
Alves A, Panis Y, Lelong B, Dousset B, Benoist S, Vicaut E.
Randomized clinical trial of early versus delayed temporary
stoma closure after proctectomy. Br J Surg 2008;95(6):693-8
8.
Menegaux F, Jordi-Galais P, Turrin N, Chigot JP. Closure of
small bowel stomas on postoperative day 10. Eur J Surg
2002;168(12):713-59. Perez RO, Habr-Gama A, Seid VE,
Proscurshim I, Sousa AH Jr, Kiss DR, et al. Loop ileostomy
morbidity: timing of closure matters. Dis Colon Rectum
2006;49(10):1539-45. 1
9.
Carlsen E, Bergan AB. Loop ileostomy: technical aspects and
complications. Eur J Surg 1999;165(2):140-3
10. Chude GG, Ravate NV, Patris V, Koshariva M, Jagad R, Kawamoto
J, et al. Defunctioning loop ileostomy with low anterior
resection for distal rectal cancer: Should we make an ileostomy
as a routine procedure. A prospective randomized study.
Hepatogastroenterology. 2008;55:1562-7.
11. Rondelli F, Reboldi P, Rulli A, Barberini F, Guerrisi A, Izzo L, et
al. Loop ileostomy for fecal diversion after colorectal or coloanal
anastomosis: ameta-analysis. Int J Colorrectal Dis. 2009;24:479-88.
12. Tang CL, Seow-Choen F, Fook-Chong S, Eu KW. Bioresorbable
adhesion barrier facilates early closure of the defunctioning
ileostomy after rectal excision: A prospective, randomized
trial. Dis Colon Rectum. 2003;46:1200-7.
13. Shabbir J, Britton DC. Stoma complications: A literature
overview. Colorectal Dis. 2010;12:958-64.
14. Perez RO, Habr-Gama A, Seid VE, Proscurshim T, Sousa AH,
Kiss DR, et al. Loop ileostomy morbidity: Timing of closure
matters. Dis Colon Rectum. 2006;49:1539-45.
15. Thalheimer A, Bueter M, Kortuem M, Thiede A, Meyer
D. Morbidity of temporary loop ileostomy in patients with
colorectal cancer. Dis Colon Rectum. 2006;49:1011-7.
16. Wijesuriya SR, Hewavisenthi J, Deen KI. Patiens with rectal
cancer having neoadyuvant chemoradiation do not have
increased complications of ileostomy closure. Ceylon Med.
2010;55:115-7.
17. Ruiz MD, Durán MC, Rivera S y cols. Calidad de vida y
necesidades de personas ostomizadas y sus cuidadores.
Rev ROL Enf 2003; 26: 309-14.
18. Turnbull GB, Colwell J, Erwin-Toth P. Quality of life : pre,
post and beyond ostomy surgery. Clinician strategies for
helping people with a stoma lead helthy productive lives.
Ostomy Wound Management 2004; 50: 2-12.
19. Furlani R, Ceolim MF. Living with a permanent intestinal
stoma: changes told by stoma patient. Rev Bras Enferm
2002; 55: 586-91.
20. Eypasch E, Williams JI, Wood-Dauphinee S, Ure BM,
Schmülling C, Neugebauer E, et al. Gastrointestinal Quality
of Life Index: development, validation and application of a
new instrument. Br J Surg 1995;82:216-22.