Laparoscopy-assisted loop ileostomy: an acceptable option for temporary fecal diversion after anorectal surgery.

PURPOSE Temporary fecal diversion may be desired after many anorectal procedures. The aim of this study was to describe a technique for laparoscopy-assisted creation of a loop ileostomy in patients undergoing anorectal and perineal surgery and to relate short-term outcomes. METHODS A retrospective review of the medical records of 53 consecutive patients who underwent laparoscopy-assisted creation of a loop ileostomy as an adjunct to anorectal or perineal surgery between 1993 and 1999 was performed. Data were obtained for age of the patient, previous abdominal surgical procedures, anorectal or perineal surgical procedure performed, American Society of Anesthesiology scores, operative times for both creation and takedown of the ileostomy, and postoperative return of bowel function. RESULTS The average duration of operation for laparoscopy-assisted creation of the loop ileostomy was 47 (range, 28-75) minutes, with no conversions to laparotomy. All patients were able to tolerate a regular diet on the first postoperative day. Closure was accomplished 69 (range, 63-96) days later with an average operative time of 52 (range, 35-90) minutes. One patient developed ileus after takedown of his stoma. The other 52 patients were able to tolerate a regular diet by the second postoperative day. CONCLUSION Laparoscopy-assisted creation of a loop ileostomy is an effective method for temporary fecal diversion in patients undergoing anorectal surgery.