Ghost ileostomy after anterior resection for rectal cancer: a preliminary experience
- 441 Downloads
The aim of this study was to describe and evaluate the feasibility and the eventual advantages of ghost ileostomy (GI) versus covering stoma (CS) in terms of complications, hospital stay and quality of life of patients and their caregivers after anterior resection for rectal cancer.
In this prospective study, we included patients who had rectal cancer treated with laparotomic anterior resection and confectioning a stoma (GI or CS), in the period comprised between January 2008 and January 2009. Short-term and long-term surgery-related mortality and morbidity after primary surgery (including that stoma-related and colorectal anastomosis-related) and consequent to the intervention of intestinal recanalization (CS group) and GI closure were evaluated. We evaluated hospital stay and quality of life of patients and their caregivers.
Stoma-related morbidity rate was higher in the CS group than in GI group (37% vs. 5.5%, respectively, P = 0.04). Morbidity rate after intestinal recanalization in the CS group was 25.9% and 0% after GI closure (P = 0.08). Overall stoma morbidity rate was significantly lower in the GI group with respect to CS group (5.5% vs. 40.7%, respectively, P = 0.03). CS group was characterized by a significantly longer recovery time (P = 0.0002). Caregivers and stoma-related quality of life were better in the GI group than in CS group (P < 0.0001 and P = 0.0005, respectively).
GI is feasible, characterized by shorter recovery, lesser degree of total, as well as anastomosis-related morbidity and higher quality of life of patients and the caregivers in respect to CS. We suggest that GI (should be evaluated as an alternative to conventional ileostomy) could be indicated in selected patients that do not present risk factors, but require caution for anastomotic leakage for the low level of colorectal anastomosis.
KeywordsRectal cancer Covering stoma Ghost ileostomy Anterior resection Stoma Quality of life
American Joint Committee on Cancer staging for rectal cancer
Stoma quality of life index
Caregiver quality of life index-cancer
Body mass index
American Society of Anesthesiologists
Conflicts of interest
- 4.Montedori A, Cirocchi R, Farinella E, Sciannameo F, Abraha I (2010) Covering ileo- or colostomy in anterior resection for rectal carcinoma. Cochrane Database Syst Rev CD006878Google Scholar
- 32.Hignett S, Parmar CD, Lewis W, Makin CA, Walsh CJ (2011) Ileostomy formation does not prolong hospital length of stay after open anterior resection when performed within an enhanced recovery programme. Colorectal Dis (in press)Google Scholar
- 37.Guenaga KF, Lustosa SA, Saad SS, Saconato H, Matos D (2007) Ileostomy or colostomy for temporary decompression of colorectal anastomosis. Cochrane Database Syst Rev CD004647Google Scholar
- 57.de la Quintana Jimenez P, Pastor Juan C, Prados Herrero I, Perez Lopez C, Gonzalez Fuentes M, de Mena Casaseca C et al (2010) A prospective, longitudinal, multicenter, cohort quality-of-life evaluation of an intensive follow-up program for patients with a stoma. Ostomy/Wound Management 56:44–52PubMedGoogle Scholar