{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T13:12:36Z","timestamp":1762866756277},"reference-count":18,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2015,11,17]],"date-time":"2015-11-17T00:00:00Z","timestamp":1447718400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Diverting loop ileostomy (<jats:styled-content style=\"fixed-case\">DLI<\/jats:styled-content>) is used following low anterior resections (<jats:styled-content style=\"fixed-case\">LAR<\/jats:styled-content>) or ultra\u2010low anterior resections (<jats:styled-content style=\"fixed-case\">ULAR<\/jats:styled-content>) to reduce anastomotic leak (<jats:styled-content style=\"fixed-case\">AL<\/jats:styled-content>). Preoperative mechanical bowel preparation (<jats:styled-content style=\"fixed-case\">MBP<\/jats:styled-content>) is traditionally used with <jats:styled-content style=\"fixed-case\">DLI<\/jats:styled-content>. However, clearance of the left colon can be achieved with a fleet enema without the physiological compromise of <jats:styled-content style=\"fixed-case\">MBP<\/jats:styled-content>. We aimed to assess colonic transit following <jats:styled-content style=\"fixed-case\">DLI<\/jats:styled-content> in this context.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective, observational study was performed with patients with rectal cancer undergoing <jats:styled-content style=\"fixed-case\">LAR<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">ULAR<\/jats:styled-content> in a tertiary colorectal unit with preoperative fleet enema. Radiopaque markers were inserted into the caecum following rectal resection and formation of a <jats:styled-content style=\"fixed-case\">DLI<\/jats:styled-content> with placement confirmed by image intensifier and endoscopy. X\u2010rays were performed at days 1, 3, 5 and 14 post\u2010operation with data collected prospectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ten patients (mean age 57, nine males) were enrolled. Mean time to functioning stoma was 1.9 days (range 1\u20133). There was no movement in the majority of markers in all patients at Day 5 post\u2010operation. In all seven patients with Day 14 X\u2010rays, the majority of markers remained in the right colon. Two patients had delayed <jats:styled-content style=\"fixed-case\">AL<\/jats:styled-content>, with markers found within the pelvis in both of these patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This is the first study to assess colonic transit following <jats:styled-content style=\"fixed-case\">DLI<\/jats:styled-content> using fleet enema only, with results suggesting colonic motility is abolished in this setting. The use of a fleet enema without <jats:styled-content style=\"fixed-case\">MBP<\/jats:styled-content> may be sufficient prior to rectal resection surgery when <jats:styled-content style=\"fixed-case\">DLI<\/jats:styled-content> is employed. <jats:styled-content style=\"fixed-case\">AL<\/jats:styled-content> may actually increase colonic transit. Further research is warranted.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.13376","type":"journal-article","created":{"date-parts":[[2015,11,17]],"date-time":"2015-11-17T07:28:44Z","timestamp":1447745324000},"page":"795-799","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Colonic transit: what is the impact of a diverting loop ileostomy?"],"prefix":"10.1111","volume":"87","author":[{"given":"Sean","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery Alfred Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary","family":"Theophilus","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Alfred Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiamei","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Alfred Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen W.","family":"Bell","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Alfred Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roger","family":"Wale","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Alfred Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Chin","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Alfred Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chip","family":"Farmer","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Alfred Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satish K.","family":"Warrier","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Alfred Health  Melbourne Victoria Australia"},{"name":"Department of Colorectal Surgery Peter MacCallum Cancer Centre  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,11,17]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.4651"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800811139"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.5524"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-011-1361-y"},{"key":"e_1_2_5_6_1","first-page":"385","article-title":"Preoperative bowel preparation for patients undergoing elective colorectal surgery: a clinical practice guideline endorsed by the Canadian Society of Colon and Rectal Surgeons","volume":"53","author":"Eskicioglu C","year":"2010","journal-title":"Can. 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