DOI: 10.36347/sjams.2019.v07i06.010

Pages: 2092-2097

Introduction: Anorectal pathologies whether benign or malignant often require a faecal diversion before a definitive management is carried out. The various options available are midline laparotomy, laparoscopic diversion and diversion through a small transverse incision over the left iliac fossa. Aims and objectives: The aim of this study is to evaluate the benefits of a loop sigmoid colostomy through a small LIF transverse incision as compared to a diversion done through a laparoscopic approach. Method: A prospective clinical study was carried out on sixty patients with benign anorectal pathologies requiring faecal diversion. Thirty patients were randomly assigned to undergo loop sigmoid colostomy through a small LIF transverse incision and the remaining was assigned to undergo laparoscopic diversion. Patients with acute intestinal obstruction and anorectal malignancies were excluded from the study. Results: The patients who underwent sigmoid colostomy through a small transverse LIF incision had reduced hospital stay with less post-operative morbidity, early return to feeding, with minimal incidence of post-operative sub-acute obstruction due to adhesions. In addition, this procedure could be done under spinal anaesthesia and even safe in the hands of surgical residents and easy to learn. It can even be undertaken in patients in whom laparoscopy is contraindicated. Conclusion: Though laparoscopy is now the preferable mode of surgery over open procedures this study reveals that the sigmoid colostomy through a small transverse LIF incision has definitive advantage over laparoscopic diversion.