The Barcelona Technique for Ileostomy Reversal

• Published in: Journal of gastrointestinal surgery Vol. 19; no. 12; pp. 2269 - 2272
• Main Authors: Russell, Katie W., O’Holleran, Brigid P., Bowen, Megan E., Mone, Mary C., Scaife, Courtney L.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.12.2015; Springer Nature B.V
• Subjects: Abdomen; Abscesses; Adult; Aged; Aged, 80 and over; Anastomosis, Surgical - methods; Colorectal cancer; Cost control; Female; Gastroenterology; How I do it; Humans; Ileostomy - adverse effects; Ileostomy - methods; Infections; Inflammatory bowel disease; Length of stay; Male; Medicine; Medicine & Public Health; Middle Aged; Ostomy; Patients; Rectal Neoplasms - surgery; Retrospective Studies; Surgeons; Surgery; Surgical outcomes; Suture Techniques; Barcelona technique of Ravitch; Bowel anastomosis; Ileostomy reversal; Barcelona technique
• ISSN: 1091-255X; 1873-4626
• DOI: 10.1007/s11605-015-2929-6

Introduction The Barcelona technique for bowel anastomosis is not well described in the currently available literature, but it saves steps when compared to conventional stapled anastomoses. In short, the proximal and distal ends of a resection margin are approximated, small enterotomies made, a stapler is passed into both lumens creating a common channel, and lastly, this same stapler is used to create the anastomosis and amputate the specimen. We report on this technique with ileostomy reversal in terms of cost and complications. Materials and Methods Review of ileostomy reversals (2006–2014) by a single surgical oncologist. Results Thirty patients had surgery using the Barcelona technique. Median age was 58 years, and median postoperative surgical stay was 3 days. The majority of patients had rectal cancer initially treated with low anterior resection and diverting loop ileostomy (80 %). One patient had a wound infection (3 %), and there were no anastomotic leaks, intra-abdominal abscesses, or strictures. This technique required fewer stapler loads saving $510 in charges per case. Conclusions The Barcelona technique is safe and effective for ileostomy reversal. There are reduced costs related to equipment as compared to the conventional technique and thus the use of this method can result in significant medical cost savings.