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Published in:

01-09-2015

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

Authors: Francesco Saverio Mari, Tatiana Di Cesare, Luciano Novi, Marcello Gasparrini, Giammauro Berardi, Giovanni Guglielmo Laracca, Andrea Liverani, Antonio Brescia

Published in: Surgical Endoscopy | Issue 9/2015

Abstract

Background

Anastomotic leakage following anterior rectal resection is the most important and most commonly faced complication of laparoscopy and open surgery. To prevent this complication, the construction of a preventing stoma is usually adopted. It is not easy to decide whether to construct a protective stoma in patients with a medium risk of anastomotic leakage. In these patients, ghost ileostomy (GI), a pre-stage ileostomy that can be externalized and opened if needed, has proved useful. We conducted a prospective, randomized, controlled study to evaluate the advantages of GI in laparoscopic rectal resection.

Methods

All patients with surgical indications for laparoscopic rectal resection who were at medium risk for anastomotic leakage from January 2007 to January 2013 were included and were randomly divided in 2 groups. All of the patients were subjected to laparoscopic anterior rectal resection with the performance of GI (group A) or without the construction of any protective stoma (group B). The presence and severity of clinically evident postoperative anastomotic leakage and other postoperative complications and reinterventions were investigated.

Results

Of the 55 patients allocated to group A, 3 experienced anastomotic leakage compared with 4 in group B. The patients with GI experienced a lower severity of anastomotic leakage and shorter hospitalization compared with the patients in group B. None of the patients with GI and anastomotic leakage required laparotomy to treat the dehiscence.

Conclusions

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.

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Title: Does ghost ileostomy have a role in the laparoscopic rectal surgery era? A randomized controlled trial
Authors: Francesco Saverio Mari
Tatiana Di Cesare
Luciano Novi
Marcello Gasparrini
Giammauro Berardi
Giovanni Guglielmo Laracca
Andrea Liverani
Antonio Brescia
Publication date: 01-09-2015
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 9/2015
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-014-3974-z

2024 ASCO Annual Meeting

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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