Completely Diverted Tube Ileostomy Versus Conventional Loop Ileostomy

Abstract

Diverting ileostomies are commonly performed to prevent morbidity and mortality caused by colorectal anastomotic leakage. However, many complications may develop due to loop ileostomy itself and its reversal. In this study, we aimed to compare the outcomes of completely diverted tube ileostomy and conventional loop ileostomy. MethodsThe study was designed prospectively, and operations were performed by the same surgeon at a single center. Completely diverted tube ileostomy with the rubber strip was performed in 20 consecutive patients, and loop ileostomy was performed in the next 20 consecutive patients who needed diverting stoma. The primary outcome of the study is to compare the overall complication rates in both techniques. Length of hospital stay, achieving complete diversion, and length of time with a stoma were evaluated as secondary outcomes. ResultsThere were no significant differences in the demographic characteristics between the two groups. Complete diversion was achieved in both groups. The number of patients who developed any kind of complications during the observation period was significantly higher in the loop ileostomy group in comparison with the tube ileostomy group (13 (65%) versus 3 (15%), respectively (p=0.002)). The median time with a stoma was significantly higher in the loop ileostomy group compared to the tube ileostomy group (270 days (range: 56-443) versus 21 days (range: 14-28), respectively (p<0.001)). ConclusionCompletely diverted tube ileostomy causes fewer complications, provides a cost advantage, and does not require surgery for stoma closure.