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

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.