Standardization of preoperative stoma site marking and its utility for preventing stoma leakage: a retrospective study of 519 patients who underwent laparoscopic/robotic rectal cancer surgery

PURPOSE

Stoma site marking is an important preoperative intervention for preventing various stoma-associated complications. In our institution, standardized stoma site marking is routinely performed before rectal cancer surgery with stoma creation, and various stoma-associated factors are recorded in the ostomy-record template. The present study investigated risk factors for stoma leakage.

METHODS

Our stoma site marking is standardized so that it can be performed by non-stoma specialists. To identify risk factors of stoma leakage at 3 months after surgery, various preoperative factors associated with stoma site marking in our ostomy-record template were retrospectively analyzed in 519 patients who underwent rectal cancer surgery with stoma creation from 2015 to 2020.

RESULTS

Stoma leakage was seen in 35 of the 519 patients (6.7%). The distance between the stoma site marking and the umbilicus was less than 60 mm in 27 of the 35 patients (77%) who experienced stoma leakage, so a distance of less than 60 mm was identified as an independent risk factor for stoma leakage. Aside from preoperative factors, stoma leakage was also caused by postoperative skin wrinkles or surgical scars near the stoma site in 8 of 35 patients (23%).

CONCLUSION

Preoperative standardized stoma site marking is necessary to achieve reliable marking that is easy to perform. To reduce the risk of stoma leakage, a distance of 60 mm or more between the stoma site marking and the umbilicus is ideal, and surgeons need to contrive ways to keep surgical scars away from the stoma site.

Introduction of retired breeder F344/DuCrj rats for aging research

Male retired breeder F344/DuCrj rats of 17 months of age were purchased in three lots and maintained for aging studies until 25 months of age. These rats were compared with male virgin rats of the same strain for survival percentage, body weight and food consumption. In the retired breeders, decrease in body weight and low food consumption were noted after delivery, and one or two months were required for these parameters to return to the delivery level. After recovery, the body weight and food consumption as well as survival percentage in the retired breeders were similar to those in virgins. From our results, we consider that it takes one to two months to acclimatize aged rats.

Outbreak of neonatal canine herpesvirus infection in a specific pathogen-free beagle colony

Nine out of 19 newborn pups from 4 litters died or euthanatized on day 10 to 17 after birth in a specific-pathogen-free beagle colony which had been established by cesarean section and bottle-feeding. Necropsy showed congestion and edema of the lungs, congestion of the liver and splenomegaly, as well as many subcapsular petechiae and wedge-shaped areas of ecchymosis on the cut surface of the kidneys. A cytopathic agent isolated from the lungs, kidneys and liver was identified as a canine herpesvirus. The bitches in the animal house were seroconverted into positive for the isolate after the outbreak of the disease. Histopathological lesions in six cases were characterized by multiple necrosis and hemorrhage in various organs. In addition, fibrinoid necrosis was seen in the arterial walls in wedge-shaped necrotic areas of the kidneys. The outbreak appeared to be temporary, since the same disease has not occurred in the colony up to the present time.

[Giardiasis in guinea pigs: a case report]

During the quarantine of 15 guinea pigs acquired from a breeder in February 1983, several became weak and moribund, and one died. A tremendous number of Giardia sp. bodies were detected from stamp smear preparations of the duodenal contents of some necropsied animals in this group. Histopathological examinations of the intestine revealed slight inflammatory changes and cystic enlargement of the crypts in the duodenal and jejunal mucous membranes. From these findings and the fact that other major pathogenic organisms were not detected, this disease was diagnosed as giardiasis in guinea pigs.

[Prevalence of protozoans helminths among cats purchased for experimental use in the Kanto Area]

Prevalence of protozoan and helminth parasites in adult cats for experimental use obtained from Kanto area, Japan during the period of 1973-74 (91 cats) and 1980-81 (80 cats) was investigated by means of autopsy, fecal examination and serological tests. No protozoa were found in blood smear specimens. The rate of positive Toxoplasma antibody tests was 65.4% (hemagglutination test) in 1973-74 and 26.3% (latex agglutination test) in 1980-81. Oocysts of coccidia found in feces were Isospora felis and I. rivolta. In the intestine of 63.7% (1980-81) and 69.2% (1973-74) of the cats, one or more species of helminth parasites were found. The helminth parasites found in the intestine were Toxocara cati, Ancylostoma tubaeforme, Taenia taeniaeformis, Dipylidium caninum, Spirometra erinacei and Pharyngostomum cordatum. Physaloptera sp., Dirofilaria immitis, Clonorchis sinensis and Capillaria plica were found in the stomach, heart, bile duct and urinary bladder, respectively. Differences between the results in 1973-74 and that in 1980-81 were discussed.

Isolation and properties of sialodacryoadenitis virus of rats

Pathogenic agents were isolated from affected salivary glands of rats with sialodacryoadenitis (SDA) by means of intercerebral inoculation to newborn mice and inoculation to primary rat kidney cell cultures. The properties of these isolates, irrespective of the isolation techniques, were in general agreement with that of SDA virus strain 681, and they were identified as SDA virus. In addition to the known properties, following characteristics were noticed: (1) Particles of SDA virus bore two different long and short surface projections. (2) Some antigenic differences were observed between the present isolate 930-10 and the strain 681. (3) It was suggested that SDA virus grew better at 35 degrees C than at 31 degrees, 33 degrees, 37 degrees or 39 degrees C. (4) SDA virus did not propagate in DBT cells.