The "Clover" solution - 4-lumen double-loop stoma in managing multifocal intestinal obstruction due to peritoneal metastases

“三叶草”解决方案——四腔双袢造口术治疗腹膜转移引起的多灶性肠梗阻

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Abstract

Multifocal intestinal obstruction (IO) due to peritoneal metastases (PM) presents significant surgical challenges, with traditional approaches often falling short. The Clover stoma, a four-lumen technique, combines a loop ileostomy and transverse loop colostomy into a single stoma, decompressing both small and large bowel while minimizing complications. In six patients with multifocal IO, it effectively relieved symptoms, prolonged obstruction-free intervals, and prevented re-obstructions. This technique simplifies stoma care, improves postoperative recovery, and can be adapted as disease progresses. The Clover stoma offers a promising strategy for managing complex IO in PM patients, enhancing surgical outcomes and quality of life in this challenging population.

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