Efficacy of laparoscopic surgery for loop colostomy: a propensity-score-matched analysis

PURPOSE

Colostomy is a common procedure for fecal diversion, but the optimal colostomy approach is unclear in terms of surgical outcomes and stoma-related complications. The purpose of this study was to examine the efficacy and feasibility of laparoscopic loop colostomy.

METHODS

This retrospective cohort study included patients who underwent loop colostomy at Shizuoka Cancer Center in Japan between April 2010 and March 2022. Patients were divided into two groups based on surgical approach: the laparoscopic (LAP) and open (OPEN) groups. Surgical outcomes and the incidences of stoma-related complications such as stomal prolapse (SP), parastomal hernia (PSH), and skin disorders (SD) were compared with and without propensity score matching.

RESULTS

Of the 388 eligible patients, 180 (46%) were in the LAP group and 208 (54%) were in the OPEN group. The male-to-female ratio was 5.5:4.5 in the Lap group and was 5.3:4.7 in the OPEN group, respectively. The median age was 68 years (range, 31-88 years) in the LAP group and 65 years (range, 23-93 years) in the OPEN group, respectively. The LAP group, compared with the OPEN group, had a shorter operative time and lower incidences of surgical site infection (3.9% versus 16.3%, respectively; p < 0.01) and SD (11.7% versus 24.5%, respectively; p < 0.01). There was no significant difference between the LAP and OPEN groups in the incidence of SP (17.3% versus 17.3%, respectively) or PSH (8.9% versus 6.7%, respectively). After propensity score matching, the incidences of surgical site infection and SD were significantly lower in the LAP group than in the OPEN group, while there were no significant differences in the operative time or the incidences of SP and PSH.

CONCLUSION

Our results suggest that laparoscopic surgery could be beneficial and feasible in loop colostomy.

Distribution of Phytophthora vignae f. sp. adzukicola Races in Adzuki Bean Fields in Hokkaido, Japan

Information on the distribution of races of Phytophthora vignae f. sp. adzukicola in Hokkaido, Japan, is important for the management of Phytophthora stem rot of adzuki bean. In all, 107 isolates of P. vignae collected between 1999 and 2001 from 63 fields were evaluated for patho-type using four differentials. In this study, 26, 52, and 28 isolates were identified as races 1, 3, and 4, respectively. One isolate was nonpathogenic on the differentials. Race 4 isolates had the broadest host range and were widely distributed in the adzuki bean-producing regions, especially in central and western Hokkaido. Additional management measures for P. vignae are required if the cultivation area of an agronomically promising cultivar like cv. Syumari (susceptible to race 4) is to be increased.

[Relationship between dietary fiber intake and food intake patterns of the general population, evaluated by a regional nutrition survey]

This study was performed to estimate the dietary fiber intake calculated using individual food intake data and the dietary fiber tables, and to ascertain the relationship between food intake patterns and dietary fiber intake of the general population. The 805 subjects over 15 years old were obtained from the Tottori Prefecture Nutrition Survey. The results are summarized as follows: 1. The average dietary fiber intake per capita per day was 18.19 g; 18.67 g in men, and 17.81 g in women. Dietary fiber intake per energy was different among sexes and ages: women had more dietary fiber than men and the aged had more than the young. Those who had high fiber intake per energy took green vegetables, fruits, milk, soybean products, seaweed and potatoes more frequently, and did not take oil so frequently. 2. Total dietary fiber intake from 20 food-group sources was analyzed by Multiple Regression Analysis. For both men and women fruits, vegetables and soybean products mostly influenced dietary fiber intake. 3. Based on the intake of the 20 food-groups obtained from 356 men and 449 women, the correlation matrix among these foods was calculated. The correlation matrix was also submitted to a Principal Component Analysis. The result of the Principal Component Analysis told that food intake patterns were different among the levels of dietary fiber intake. Food intake patterns of men and women who had high fiber intake per energy had an eating pattern characterized by relatively more non-processed vegetable food, bread and milk. 4. The level of blood pressure was significantly related to dietary fiber intake per energy in men over 60 years old. In the hypertensive men over 60 years old, 23.3% were in the low fiber intake group, 37.2% in the middle group, and 39.5% in the high group. But in the normal blood pressure men over 60 years old, 50.0% were in the low fiber intake group, 8.3% in the middle group, and 41.7% in the high group.