title: Is the Use of a Support Bridge Beneficial for Preventing Stomal Retraction After Loop Ileostomy? A Prospective Nonrandomized Study.
abstract: OBJECTIVE
  A temporary defunctioning loop ileostomy is frequently created during low colorectal or coloanal anastomosis to prevent peritoneal sepsis associated with anastomotic leakage. We investigated whether routine support bridge placement prevents stoma retraction after the formation of a loop ileostomy.
  
  
  METHODS
  Prospective, nonrandomized trial.
  
  
  METHODS
  The study sample comprised 32 consecutive patients who underwent defunctioning loop ileostomy at an academic tertiary care center in Seoul Korea from February to September 2010.
  
  
  METHODS
  Patients were nonrandomly allocated to "no bridge," "short-term bridge" (1 week), and "long-term bridge" (3 weeks) groups based on the surgeon's clinical judgment. Group differences in stoma height changes over time were analyzed.
  
  
  RESULTS
  Subjects' mean age was 59.5 (range: 43-82) years, and the male-to-female ratio was 2.2:1.0. The mean heights of the stoma on postoperative day 2 and postoperative month 3, respectively, were 1.07 ± 0.16 cm (mean ± SD) and 0.81 ± 0.17 cm in the no-bridge group, 1.70 ± 0.29 cm and 1.21 ± 0.18 cm in the short-term bridge group, and 1.18 ± 0.16 cm and 1.01 ± 0.20 cm in the long-term bridge group. The changes in the stoma height 3 months after the surgery showed no statistically significant differences among the groups (P = .430). Stoma Quality of Life scores at 3 weeks (47.4 vs 46.1; P = .730) were similar for patients with and without bridges. However, a significantly greater number of patients with bridges reported difficulty with pouch changes compared to those without bridges (72.7% vs 14.3%; P = .002).
  
  
  CONCLUSIONS
  Routine use of support bridges during loop ileostomy is unnecessary and inconvenient to patients. If a support bridge must be used, it can be removed early.
authors.affiliation: Heung-Kwon Oh, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. Eon Chul Han, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. Yoon Suk Song, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. Mi Sun Seo, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. Seung-Bum Ryoo, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. Seung-Yong Jeong, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. Kyu Joo Park, MD, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Heung-Kwon
authors.initials: HK
authors.lastname: Oh
authors.forename: Eon Chul
authors.initials: EC
authors.lastname: Han
authors.forename: Yoon Suk
authors.initials: YS
authors.lastname: Song
authors.forename: Mi Sun
authors.initials: MS
authors.lastname: Seo
authors.forename: Seung-Bum
authors.initials: SB
authors.lastname: Ryoo
authors.forename: Seung-Yong
authors.initials: SY
authors.lastname: Jeong
authors.forename: Kyu Joo
authors.initials: KJ
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007081:Ileostomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D011788:Quality of Life; D054047:Surgical Stomas