Ileostomy Closure के लिए जरूरी Tests! | Step by Step Tests & Safety Tips! |Dr Praveen Kammar, Mumbai

Hi, I’m Dr. Praveen Kammar, Cancer Surgeon (Cancer Surgeon Specializing in Digestive System and Gynecological Cancers) & In today’s video, we will talk about an important topic, what tests should be done before closing a temporary Ileostomy or Colostomy after rectal cancer surgery. This step, also known as stoma reversal, should only be done once we are sure the intestines have healed completely and safely.
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The Video Flow:
0:00 – Introduction
0:20 – Topic Overview
2:15 – Purpose of Temporary Stoma
2:40 – Importance of Evaluation
2:55 – Gastrografin Enema
4:15 – Why Healing Check Matters
5:00 – Enema vs Loopogram
6:00 – Clinical Examination
7:00 – Follow-up Tests
7:50 – Preoperative Tests & Fitness
8:20 – Gap After Chemotherapy
9:00 – Conclusion
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Ileostomy Closure के लिए जरूरी Tests! | Step by Step Tests & Safety Tips! |Dr Praveen Kammar, Mumbai

What is the most important test before stoma reversal?
The key test is the Gastrografin Enema Study.
It is a radiographic test where Gastrografin dye is passed through the rectum to check if the intestine connection or anastomosis has healed and there is no leakage.
This test has replaced the older loopogram because it is more accurate and patient friendly.

Why is healing assessment so important?
If the anastomosis has not healed properly, early reversal can cause leakage or blockage.
The Gastrografin Enema helps detect leaks or narrowing before surgery.
If narrowing is found, dilation can be done first for a safer outcome.

What clinical examination is needed before closure?
A digital or finger examination helps the surgeon assess healing and check for narrowing, especially in low rectal cancer cases.
It is a simple but essential part of the evaluation.

What follow up tests are needed before ileostomy closure?
If your rectal cancer treatment finished more than three months ago, you will need Complete Blood Count, tumor marker CEA and other routine blood tests.
If about a year has passed, a CT scan may be advised to confirm internal healing and rule out recurrence.

Is colonoscopy required before stoma reversal?
Yes, especially if a full colonoscopy was not possible before the initial surgery.
It helps check the entire large intestine and ensures there are no new lesions or blockages.

What preoperative and fitness tests are done?
Tests like hemoglobin, platelet count, white blood cell count, liver function tests, electrolytes and viral markers are done to confirm you are fit for surgery.
Good preoperative fitness reduces the chance of complications.

How long should you wait after chemotherapy?
Usually, we wait four to six weeks after completing chemotherapy before performing stoma reversal.
This gives time for blood counts to recover and makes surgery safer.

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About Dr. Praveen Kammar

Dr Praveen Kammar is a surgical oncologist practising in the city of Mumbai.
He completed his MCh course in surgical oncology from the reputed Tata Memorial Centre, Mumbai, one of the premier cancer care centres in the country. He also holds a fellowship in Colorectal surgery from Yopnsei cancer centre, Seoul, South Korea. Dr Praveen’s main area of focus is colorectal and GI oncology, Gynecological cancers, minimal access surgeries for abdominal and thoracic malignancies, transanal surgeries, and sphincter-saving surgeries for rectal cancer, cytoreductive surgeries, and HIPEC for advanced abdominal cancers.

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