{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T18:49:34Z","timestamp":1784141374608,"version":"3.55.0"},"reference-count":18,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2017,11,1]],"date-time":"2017-11-01T00:00:00Z","timestamp":1509494400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100008743","name":"Society of American Gastrointestinal and Endoscopic Surgeons","doi-asserted-by":"publisher","award":["4689"],"award-info":[{"award-number":["4689"]}],"id":[{"id":"10.13039\/100008743","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Postoperative ileus is the most commonly observed morbidity following ileostomy closure. Studies have demonstrated that the defunctionalized bowel of a loop ileostomy undergoes a series of functional and structural changes, such as atrophy of the intestinal villi and muscular layers, which may contribute to ileus. A single\u2010centre study in Spain demonstrated that preoperative bowel stimulation via the distal limb of the loop ileostomy decreased postoperative ileus, length of stay and time to gastrointestinal function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A multicentre randomized controlled trial involving patients from Canadian institutions was designed to evaluate the effect of preoperative bowel stimulation before ileostomy closure on postoperative ileus. Stimulation will include canalizing the distal limb of the ileostomy loop with an 18Fr Foley catheter and infusing it with a solution of 500\u00a0ml of normal saline mixed with 30\u00a0g of a thickening agent (Nestle<jats:sup><jats:bold>\u00a9<\/jats:bold><\/jats:sup> Thicken\u2010Up<jats:sup><jats:bold>\u00a9<\/jats:bold><\/jats:sup>). This will be performed 10 times over the 3\u00a0weeks before ileostomy closure in an outpatient clinic setting by a trained Enterostomal Therapy nurse. Surgeons and the treating surgical team will be blinded to their patient's group allocation. Data regarding patient demographics, and operative and postoperative variables, will be collected prospectively. Primary outcome will be postoperative ileus, defined as an intolerance to oral food in the absence of clinical or radiological signs of obstruction, that either requires nasogastric tube insertion or is associated with two of the following on or after post\u2010operative day 3: nausea\/vomiting; abdominal distension; and the absence of flatus. Secondary outcomes will include length of stay, time to tolerating a regular diet, time to first passage of flatus or stool and overall morbidity. A cost analysis will be performed to compare the costs of conventional care with conventional care plus preoperative stimulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>This manuscript discusses the potential benefits of preoperative bowel stimulation in improving postoperative outcomes and outlines our protocol for the first multicenter study to evaluate preoperative bowel stimulation before ileostomy closure. The results of this study could have considerable implications for the care of patients undergoing ileostomy closure.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.13720","type":"journal-article","created":{"date-parts":[[2017,5,12]],"date-time":"2017-05-12T15:12:49Z","timestamp":1494601969000},"page":"1024-1029","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Study protocol evaluating the use of bowel stimulation before loop ileostomy closure to reduce postoperative ileus: a multicenter randomized controlled trial"],"prefix":"10.1111","volume":"19","author":[{"given":"R.","family":"Garfinkle","sequence":"first","affiliation":[{"name":"Division of Colon and Rectal Surgery Sir Mortimer B. Davis Jewish General Hospital Montreal Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Trabulsi","sequence":"additional","affiliation":[{"name":"Division of Colon and Rectal Surgery Sir Mortimer B. Davis Jewish General Hospital Montreal Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Morin","sequence":"additional","affiliation":[{"name":"Division of Colon and Rectal Surgery Sir Mortimer B. Davis Jewish General Hospital Montreal Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Phang","sequence":"additional","affiliation":[{"name":"Section\u00a0of Colorectal Surgery St. Paul's Hospital Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Liberman","sequence":"additional","affiliation":[{"name":"Department of Surgery McGill University Health Center Montreal Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Feldman","sequence":"additional","affiliation":[{"name":"Department of Surgery McGill University Health Center Montreal Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Fried","sequence":"additional","affiliation":[{"name":"Department of Surgery McGill University Health Center Montreal Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Boutros","sequence":"additional","affiliation":[{"name":"Division of Colon and Rectal Surgery Sir Mortimer B. 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