Improving the outcome of stoma reversal surgery.
Research type
Research Study
Full title
Improving the outcome of stoma reversal surgery.
IRAS ID
134451
Contact name
Rachael Rigby
Contact email
Research summary
Colorectal cancer and inflammatory bowel disease (IBD) are estimated to cost the NHS over £1.8 billion/year. Typically, patients who develop cancer, or chronic IBD, require surgical resection of a portion of their gut. Following removal of the diseased bowel, a temporary redirection of luminal contents to a stoma (ileostomy loop) is commonly required to allow healing, prior to re-joining of the remaining bowel at a later date. The remaining section of bowel, empty of normal content due to redirection of faecal stream, rapidly starts to waste away through lack of nutrition and cellular replenishment, often becoming chronically inflamed and scarred.
A significant proportion, approximately 20%, of patients experience reduced quality of life, e.g. inflammation and/or incontinence, following reversal and in ~5% of cases, the procedure is irreversible, leaving patients with a permanent stoma. This research aims to investigate ways to improve the health and function of the “non-functioning” bowel, to increase the success and reduce side-effects of ileostomy reversal, and thus reduce the recovery time from extensive bowel surgery. These studies aim to provide support for clinical trial of probiotic/prebiotic preparations to maintain intestinal microflora and therefore mucosal health in defunctioned bowel following stoma formation.
The project will be carried out at Lancaster University and Queen Mary University London, in collaboration with NHS surgical colleagues at Royal Preston Hospital. We have already obtained ethical approval and carried out preliminary immunohistochemical analyses on intestinal tissue derived from ileostomy loops. Removal of the ‘ileostomy loop’ provides sections of both ‘functional’ and ‘non-functional’ bowel. These samples represent a unique opportunity to analyse functional and non-functional tissue and microflora, within the same individual, providing us with an ‘internal control’ for our studies. To our knowledge, this approach to studying intestinal adaptation and microflora has not been used before.REC name
North West - Preston Research Ethics Committee
REC reference
13/NW/0695
Date of REC Opinion
15 Oct 2013
REC opinion
Favourable Opinion