Does ghost ileostomy have a role in the laparoscopic rectal surgery era? A randomized controlled trial

Abstract

The use of GI in laparoscopic rectal resections in patients at medium risk for anastomotic leakage was useful because it allowed for the avoidance of stoma creation in all of the patients, thus reducing the number of stomas performed, improving the quality of life of the patients and preserving, in most cases, the benefits gained by laparoscopy.

Anastomotic Leakage in Rectal Surgery: Role of the Ghost Ileostomy

“…This result states that AL after an AR requiring a new surgical procedure are more frequent than AL occurring after LAR and ULAR. The authors suggested that such difference could be explained considering the largest number of derivative stomy (DS) performed d'emblée in low and ultralow resections (33,34).…”

“…Nevertheless, the advantages of protective ileostomy are reduced by stoma-related complications or by subsequent surgery for ileostomy reversal, with consequent increase of the costs and duration of hospital stay. The overall incidence of clinical AL is about 8%, so that the covering ileostomy is unnecessarily performed in 92% of the cases (10,(34)(35)(36).…”

Defunctioning ileostomy reduces leakage rate in rectal cancer surgery - systematic review and meta-analysis

“…In this group of patients it is possible to create a loop ileostomy only in case of anastomotic leakage and without the need for laparotomy. However, even pioneers of this technique recommend it only in patients with low and medium risk of this complication [ 46 , 47 ]. We have observed that creating a protective stoma may be beneficial in reducing both the rate of anastomotic leakage and reoperations.…”

Method of «hidden Colostomy» in Low Anterior Resections of Rectum

“…Противники «профилактических» стом указывают на возможность развития осложнений, связанных как с ее формированием, так и с ликвидацией [7,14]. Среди такого разнообразия мнений представляют интерес публикации итальянских авторов, в которых представлен опыт формирования «призрачных» илеостом (Ghost-ileostomy) [15,16].…”

“…Полученные результаты совпадают с данными зарубежных авторов по опыту применения «при- [15,16]. Однако предлагаемый нами метод имеет ряд преимуществ.…”