Usefulness of ileostomy defunctioning stoma after anterior resection of rectum on prevention of anastomotic leakage A retrospective analysis

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COD: 07_1156_2392 Categorie: ,

Giuseppe Salamone, Leo Licari, Antonino Agrusa, Giorgio Romano, Gianfranco Cocorullo, Nicolò Falco, Roberta Tutino, Gaspare Gulotta

Ann. Ital. Chir., 2016 87: 155-160

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PURPOSES: Anastomotic leakage is one of the major complications occurring after anterior resection of rectum. A defunctioning
stoma is usually created routinely or on surgeons’ discretion. The aim of this study was to investigate the usefulness
of temporary ileostomy to prevent anastomotic leakage comparing the postoperative course of patients with and
without defunctioning loop ileostomy.
METHODS: Patients that underwent anterior resection of rectum were recruited. 140 patients were enrolled and divided
in two groups: patients without and with defunctioning loop ileostomy. Patients’ characteristics and other useful data
were recorded. A comparison between the two groups was made. The minimum follow-up was 11 months.
RESULTS AND CONCLUSIONS: 18.6% of patients had a symptomatic anastomotic leakage. We observed more anastomotic
leakages after medium-low resections of rectum with anastomosis than after resections with high anastomosis (15.7% vs
2.9%; p=0.03). There were no significant differences in overall and related mortality between patients without/with
ileostomy. The presence of ileostomy was not protective towards anastomotic leakage either in the medium-low resections
or in the high ones but it was towards its consequences such as clinical features.
Nevertheless we found a statistically significative difference between recurrence rate of leakage in patients with and without
ileostomy (p-Value=0.009).

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