| Journal: |
Journal of Coloproctology
Thieme Revinter Publicações Ltda., Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
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| Abstract: |
Introduction There has been conclusive evidence that defunctioning stoma with
either transverse colostomy or ileostomy mitigates the serious consequences of
anastomotic leakage. However,whether transverse colostomy or ileostomy is preferred
for defunctioning a rectal anastomosis remains controversial. The present study was
designed to identify the best defunctioning stoma for colorectal anastomosis.
Objective To improve the quality of life in patients with rectal resection and
anastomosis and reduce the morbidity before and after closure of the stoma.
Patients and Methods The present study included 48 patients with elective colorectal
resection who were randomly arranged into 2 equal groups, with 24 patients each. Group I
consisted of patients who underwent ileostomy, and group II consisted of patients who
underwent colostomy as a defunctioning stoma for a low rectal anastomosis. All surviving
patients were readmitted to have their stoma closed and were followed-up for 6 months
after closure of their stomas. All data regarding local and general complications of
construction and closure of the stoma of the two groups were recorded and blotted
against each other to clarify the most safe and tolerable procedure.
Results We found that all nutritional deficiencies, dehydration, electrolytes imbalance,
peristomal dermatitis, and frequent change of appliances are statistically more
common in the ileostomy group, while stomal retraction and wound infection after
closure of the stoma were statistically more common in the colostomy group. There
were no statistically significant differences regarding the total hospital stay and
mortality between the two groups.
Conclusion and Recommendation Ileostomy has much higher morbidities than
colostomy and it also has a potential risk of mortality; therefore, we recommend
colostomy as the ideal method for defunctioning a distal colorectal anastomosis
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