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Complications - Ileostomy Reversal

general and visceral surgery
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Anatomy Perioperative management Technique Complications Evidence Total Video

  1. Intraoperative Complications

    • Injury to the bowel (especially in cases of severe adhesions → extensive, careful adhesiolysis)
    • Unrecognized injury to bowel sections with leakage of stool into the free abdominal cavity and subsequent peritonitis
    • Lack of tension-free anastomosis (→ extensive adhesiolysis to mobilize both ends)
    • Bleeding (→ blood-sparing, careful surgery; experienced surgeon)
    • Injury to adjacent organs (bladder, ureter, and vas deferens) during the dissection of the distal limb
    • In cases of poor blood supply to the anastomosis ends, intraoperative resection must be performed

  2. Postoperative Complications

    • Wound infection
    • Peritonitis due to anastomotic leakage or intraoperatively unrecognized injury to other intestinal sections with leakage of stool into the free abdominal cavity
    • Enterocutaneous fistula
    • Incisional hernia (→ possibly wearing an abdominal binder for 6 weeks)
    • Postoperative ileus (→ possibly stool-regulating measures)
    • Postoperative stenosis of the anastomosis (→ good blood supply to the anastomosis, tension-free surgery; reoperation may be necessary in individual cases)