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Year 2022, Volume: 8 Issue: 3, 340 - 346, 04.05.2022
https://doi.org/10.18621/eurj.914951

Abstract

References

  • 1. Watanabe T, Miyata H, Konno H, Kawai K, Ishihara S, Sunami E, et al. Prediction model for complications after low anterior resection based on data from 33,411 Japanese patients included in the National Clinical Database. Surgery 2017;161:1597-608.
  • 2. Kim CW, Baek SJ, Hur H, Min BS, Baik SH, Kim NK. Anastomotic leakage after low anterior resection for rectal cancer is different between minimally invasive surgery and open surgery. Ann Surg 2016;263:130-7.
  • 3. Katsuno H, Shiomi A, Ito M, Koide Y, Maeda K, Yatsuoka T, et al. Comparison of symptomatic anastomotic leakage following laparoscopic and open low anterior resection for rectal cancer: a propensity score matching analysis of 1014 consecutive patients. Surg Endosc 2016;30:2848-56.
  • 4. Wu SW, Ma CC, Yang Y. Role of protective stoma in low anterior resection for rectal cancer: a meta-analysis. World J Gastroenterol 2014;20:18031-7.
  • 5. Williams NS, Nasmyth DG, Jones D, Smith AH. Defunctioning stomas: a prospective controlled trial comparing loop ileostomy with loop transverse colostomy. Br J Surg 1986;73:566-70.
  • 6. Gooszen AW, Geelkerken RH, Hermans J, LagaayMB, GooszenHG. Temporary decompression after colorectal surgery: randomized comparison of loop ileostomy and loop colostomy. Br J Surg 1998;85:76-9.
  • 7. Sakai Y, Nelson H, Larson D, Maidl L, Young-Fadok T, Ilstrup D. Temporary transverse colostomy vs loop ileostomy in diversion: a case-matched study. Arch Surg 2001;136:338-42.
  • 8. Rahbari NN, Weitz J, Hohenberger W, Heald RJ, Moran B, Ulrich A, et al. Definition and grading of anastomotic leakage following anterior resection of the rectum: a proposal by the International Study Group of Rectal Cancer. Surgery 2010;147:339-51.
  • 9. Abdulmohaymen AM. Comparative study of loop ileostomy vs loop transverse colostomy as a covering stoma after low anterior resection for rectal cancer. Al-Azhar Assiut Med J 2020;18:136-9.
  • 10. Sun X, Han H, Qiu H, Wu B, Lin G, Niu B, et al. Comparison of safety of loop ileostomy and loop transverse colostomy for low-lying rectal cancer patients undergoing anterior resection: A retrospective, single institute, propensity score-matched study. J BUON 2019;24:123-9.
  • 11. Chen J, Wang DR, Zhang JR, Li P, Niu G, Lu Q. Meta-analysis of temporary ileostomy versus colostomy for colorectal anastomoses. Acta Chir Belg 2013;113:330-9.
  • 12. Gavriilidis P, Azoulay D, Taflampas P. Loop transverse colostomy versus loop ileostomy for defunctioning of colorectal anastomosis: a systematic review, updated conventional meta-analysis, and cumulative meta-analysis. Surg Today 2019;49:108-17.
  • 13. Du R, Zhou J, Tong G, Chang Y, Li D, Wang F, et al. Postoperative morbidity, and mortality after anterior resection with preventive diverting loop ileostomy versus loop colostomy for rectal cancer: A updated systematic review and meta-analysis. Eur J Surg Oncol 2021;47:1514-25.
  • 14. Geng HZ, Nasier D, Liu B, Gao H, Xu YK. Meta-analysis of elective surgical complications related to defunctioning loop ileostomy compared with loop colostomy after low anterior resection for rectal carcinoma. Ann R Coll Surg Engl 2015;97:494-501.
  • 15. Ayman MAA. Loop transverse colostomy versus loop ileostomy after low and ultralow anterior resection. Int Surg J 2018;5:1633-9.

Loop ileostomy or loop transverse colostomy for resectable rectal cancers

Year 2022, Volume: 8 Issue: 3, 340 - 346, 04.05.2022
https://doi.org/10.18621/eurj.914951

Abstract

Objectives: This retrospective study aimed to compare loop ileostomy (LI) with loop transverse colostomy (LTC) as covering stoma regarding the perioperative outcomes in patients who underwent low anterior resection for rectal cancer between 2015 and 2020.


Methods:
Data were collected from patient files and the hospital's electronic database. The primary outcome measure was complications related to stoma formation, stoma reversal, and overall complications. Secondary outcome measures were hospital discharge time and readmission rate after discharge.

Results: A total of 90 patients (38 female, 52 male; 56.6 ± 6.8 years) were included in the study. There were two groups considering the technique for covering stoma: Group LI (n = 50) and Group LTC (n = 40). Demographic and perioperative characteristics were similar. Primary outcome measure: Postoperative course was complicated in 49 (54.4%) patients. The complication rate was higher in the group LI than the group LTC (62% vs 45%; p = 0.03). Among them, 29 (59.2%) complications were related to the stoma formation related, and 14 (28.6 %) complications were related to the stoma reversal related, and 6 (12.2%) were overall complications. The rate of complications related to the stoma formation was higher in the group LI compared to the group LTC (20 [40%] vs. 9 [22.5%]; p = 0.01). The most common complication was periostomal skin irritation (48.3%) followed by dehydration (13.8%), stoma retraction (10.3%) patients, parastomal hernia (10.3%), bleeding (6.9%), anastomotic leak (3.4%), incisional hernia (3.4%), and high-output stoma (3.4%). Complications including incisional hernia, high output stoma, and anastomotic leakage (Grade C; requiring laparotomy) were observed only in the group LI. The morbidity rate in 30 days after the surgery was higher in the group LI compared to the group LTC (16 [32%] vs. 8 [20%]; p = 0.02). A total of 14 stoma reversal complications included incisional hernia in 7 (14.3%) patients, wound infection in 5 (10.2%) patients, and rectal bleeding in 2 (4.1%) patients. The rate of complications was not different between groups (16% vs. 15%; p = 0.41). Overall complications were similar between study groups (3 complications in each group; p = 0.73). Secondary outcome measure: The group LTC patients were discharged earlier compared to the group LI (7.1 ± 2.0 days vs. 9.4 ± 2.5 days; p = 0.03). The readmission rate after hospital discharge was higher in the LI group than the group LTC (18% vs. 12.5%; p = 0.02).


Conclusions:
It was concluded that LTC was superior compared to LI concerning complications after low anterior resection for rectum cancer.

References

  • 1. Watanabe T, Miyata H, Konno H, Kawai K, Ishihara S, Sunami E, et al. Prediction model for complications after low anterior resection based on data from 33,411 Japanese patients included in the National Clinical Database. Surgery 2017;161:1597-608.
  • 2. Kim CW, Baek SJ, Hur H, Min BS, Baik SH, Kim NK. Anastomotic leakage after low anterior resection for rectal cancer is different between minimally invasive surgery and open surgery. Ann Surg 2016;263:130-7.
  • 3. Katsuno H, Shiomi A, Ito M, Koide Y, Maeda K, Yatsuoka T, et al. Comparison of symptomatic anastomotic leakage following laparoscopic and open low anterior resection for rectal cancer: a propensity score matching analysis of 1014 consecutive patients. Surg Endosc 2016;30:2848-56.
  • 4. Wu SW, Ma CC, Yang Y. Role of protective stoma in low anterior resection for rectal cancer: a meta-analysis. World J Gastroenterol 2014;20:18031-7.
  • 5. Williams NS, Nasmyth DG, Jones D, Smith AH. Defunctioning stomas: a prospective controlled trial comparing loop ileostomy with loop transverse colostomy. Br J Surg 1986;73:566-70.
  • 6. Gooszen AW, Geelkerken RH, Hermans J, LagaayMB, GooszenHG. Temporary decompression after colorectal surgery: randomized comparison of loop ileostomy and loop colostomy. Br J Surg 1998;85:76-9.
  • 7. Sakai Y, Nelson H, Larson D, Maidl L, Young-Fadok T, Ilstrup D. Temporary transverse colostomy vs loop ileostomy in diversion: a case-matched study. Arch Surg 2001;136:338-42.
  • 8. Rahbari NN, Weitz J, Hohenberger W, Heald RJ, Moran B, Ulrich A, et al. Definition and grading of anastomotic leakage following anterior resection of the rectum: a proposal by the International Study Group of Rectal Cancer. Surgery 2010;147:339-51.
  • 9. Abdulmohaymen AM. Comparative study of loop ileostomy vs loop transverse colostomy as a covering stoma after low anterior resection for rectal cancer. Al-Azhar Assiut Med J 2020;18:136-9.
  • 10. Sun X, Han H, Qiu H, Wu B, Lin G, Niu B, et al. Comparison of safety of loop ileostomy and loop transverse colostomy for low-lying rectal cancer patients undergoing anterior resection: A retrospective, single institute, propensity score-matched study. J BUON 2019;24:123-9.
  • 11. Chen J, Wang DR, Zhang JR, Li P, Niu G, Lu Q. Meta-analysis of temporary ileostomy versus colostomy for colorectal anastomoses. Acta Chir Belg 2013;113:330-9.
  • 12. Gavriilidis P, Azoulay D, Taflampas P. Loop transverse colostomy versus loop ileostomy for defunctioning of colorectal anastomosis: a systematic review, updated conventional meta-analysis, and cumulative meta-analysis. Surg Today 2019;49:108-17.
  • 13. Du R, Zhou J, Tong G, Chang Y, Li D, Wang F, et al. Postoperative morbidity, and mortality after anterior resection with preventive diverting loop ileostomy versus loop colostomy for rectal cancer: A updated systematic review and meta-analysis. Eur J Surg Oncol 2021;47:1514-25.
  • 14. Geng HZ, Nasier D, Liu B, Gao H, Xu YK. Meta-analysis of elective surgical complications related to defunctioning loop ileostomy compared with loop colostomy after low anterior resection for rectal carcinoma. Ann R Coll Surg Engl 2015;97:494-501.
  • 15. Ayman MAA. Loop transverse colostomy versus loop ileostomy after low and ultralow anterior resection. Int Surg J 2018;5:1633-9.
There are 15 citations in total.

Details

Primary Language English
Subjects Surgery
Journal Section Original Articles
Authors

Mehmet Ali Çaparlar 0000-0001-6466-0348

Şeref Dokçu This is me 0000-0003-1807-8108

Salim Demirci 0000-0001-9497-2190

Publication Date May 4, 2022
Submission Date April 14, 2021
Acceptance Date September 23, 2021
Published in Issue Year 2022 Volume: 8 Issue: 3

Cite

AMA Çaparlar MA, Dokçu Ş, Demirci S. Loop ileostomy or loop transverse colostomy for resectable rectal cancers. Eur Res J. May 2022;8(3):340-346. doi:10.18621/eurj.914951

e-ISSN: 2149-3189 


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