Anastomotic Leakage in Rectal Surgery: Role of the Ghost Ileostomy

Palumbo, Piergaspare; Usai, Sofia; Pansa, Andrea; Lucchese, Sara; Caronna, Roberto; Bona, Stefano

doi:10.21873/anticanres.13429

Cited by 18 publications

(24 citation statements)

References 28 publications

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“…This finding could be due to the fact that only about 11% of the patients in our study received a temporary protected ileostomy. Another possible explanation is that protective ileostomy may lead to disease-related proctitis (Palumbo et al, 2019). Another study reported that defecation function is impaired when the stoma is closed (Rubinkiewicz et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

Assessment of defecation function after sphincter-saving resection for mid to low rectal cancer: A cross-sectional study

Luo

Zheng

Yang

et al. 2021

European Journal of Oncology Nursing

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Section: Discussionmentioning

confidence: 99%

Assessment of defecation function after sphincter-saving resection for mid to low rectal cancer: A cross-sectional study

Luo

Zheng

Yang

et al. 2021

European Journal of Oncology Nursing

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“…With the proposed and extensive application of total mesorectal excision and complete mesenteric excision, the local recurrence rate and five-year survival rate of colorectal malignancies have significantly improved. The need to complete D3 lymph node dissection of tumors during radical resection of rectal and sigmoid colon cancers, based on the experience of Japan and other countries, is still controversial [12][13][14][15][16]. Currently, the boundary of lymph nodes at the root of the inferior mesenteric artery is generally defined as medial to the superior mesenteric artery, lateral to the inferior mesenteric vein, caudate to the left colic artery root, and cephalic to the inferior mesenteric artery root [17].…”

Section: Discussionmentioning

confidence: 99%

Efficacy comparison and safety analysis of radical resection of sigmoid colon cancer based on different cancer locations

Chen

Jin

et al. 2021

Preprint

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Background: Sigmoid colon cancer is a common type of colon cancer; it refers to tumor lesions occurring in the segment approximately 16 cm to 50 cm from the anal margin. Currently, surgical resection is the most effective treatment for non-metastatic sigmoid colon cancer. Therefore, to more accurately standardize colon cancer surgery, we classified the sigmoid colon into distal and proximal segments. This study compares and analyzes the intraoperative situation, postoperative pathology and safety of radical resection of sigmoid cancer in different locations from different aspects. Result: The patients with sigmoid colon tumor can be divided into distal group (16-30cm from the anus) and proximal group (31-50cm from the anus) according to the distance between the tumor and the anal margin. Conclusion: The patients in the distal group using stapler for intestinal anastomosis and anal decompression tube were significantly more than those in the proximal group. For the ligation of the inferior mesenteric artery, high ligation was usually used or the left colic artery was usually preserved in the distal group, and the superior rectal artery was usually retained in the proximal group. The incidence of postoperative complications in the distal group was higher than that in the proximal group, but there was no significant difference between the two groups.

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“…From 242 citations, 14 studies (7 retrospective cohorts, prospective cohorts, 2 letters, 1 RCT, and 1 conference proceeding) with 628 patients undergoing GI (47.3% female, mean age: 66.5, mean BMI: 26.8), 266 patients undergoing LI (41.6% female, mean age: 65.0, mean BMI: 25.7) and 52 patients not receiving a stoma (48.1% female, mean age: 69.0, mean BMI: 29.2) were included. [14][15][16][17][18][19][20][34][35][36][37][38][39][40] A PRISMA flow diagram of the study selection process is illustrated in Figure 1. 22 Included studies were conducted between 2007 and 2021.…”

Section: Study Characteristicsmentioning

confidence: 99%

Ghost Ileostomy Versus Loop Ileostomy Following Oncologic Resection for Rectal Cancer: A Systematic Review and Meta-Analysis

McKechnie

Lee

et al. 2023

Surg Innov

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Objective The aim of this study was to compare ghost ileostomy (GI) and loop ileostomy (LI) in patients undergoing oncologic resection for rectal cancer in terms of postoperative morbidity. Summary Background Data LIs are often fashioned to protect downstream anastomoses following oncologic resection for low rectal cancer at medium-to-high risk of anastomotic leak. More recently, GIs have been utilized in patients with low-to-medium risk anastomoses to reduce the rate of unnecessary stomas. Methods Medline, Embase, and CENTRAL were systematically searched. Studies investigating the use of GI in patients undergoing oncologic resection for rectal cancer were included. The primary outcomes were anastomotic leak and postoperative morbidity. Secondary outcomes included stoma-related complications and length of stay (LOS). Pairwise meta-analyses were performed with inverse variance random effects. Results From 242 citations, 14 studies with 946 patients were included. In comparative studies, 359 patients were undergoing GI and 266 patients were undergoing LI. Pairwise meta-analysis revealed no differences in the prevalence of anastomotic leak (OR 1.40, 95%CI .73-2.68, P = .31), morbidity (OR .76, 95%CI .44-1.30, P = .32), or LOS (SMD -.05, 95%CI -.33-.23, P = .72). International Study Group of Rectal Cancer anastomotic leak grades were as follows: Grade A (GI 0% vs LI 13.3%), Grade B (GI 80.9% vs LI 86.7%), Grade C (GI 19.1% vs LI 0%). Conclusions GI appears to be a safe alternative to LI following oncologic resection for rectal cancer. Larger, prospective comparative studies are warranted to evaluate the use of GI in patients deemed to be at low-to-medium risk of anastomotic leak.

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Anastomotic Leakage in Rectal Surgery: Role of the Ghost Ileostomy

Cited by 18 publications

References 28 publications

Assessment of defecation function after sphincter-saving resection for mid to low rectal cancer: A cross-sectional study

Assessment of defecation function after sphincter-saving resection for mid to low rectal cancer: A cross-sectional study

Efficacy comparison and safety analysis of radical resection of sigmoid colon cancer based on different cancer locations

Ghost Ileostomy Versus Loop Ileostomy Following Oncologic Resection for Rectal Cancer: A Systematic Review and Meta-Analysis

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