Langenbeck's Archives of Surgery

, Volume 396, Issue 7, pp 997–1007 | Cite as

Ghost ileostomy after anterior resection for rectal cancer: a preliminary experience

  • Nino Gullà
  • Stefano Trastulli
  • Carlo Boselli
  • Roberto Cirocchi
  • Davide Cavaliere
  • Giorgio Maria Verdecchia
  • Umberto Morelli
  • Daniele Gentile
  • Emilio Eugeni
  • Daniela Caracappa
  • Chiara Listorti
  • Francesco Sciannameo
  • Giuseppe Noya
Original Article

Abstract

Purpose

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.

Methods

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.

Results

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).

Conclusions

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.

Keywords

Rectal cancer Covering stoma Ghost ileostomy Anterior resection Stoma Quality of life 

Abbreviations

CS

Covering stoma

GI

Ghost ileostomy

AJCC

American Joint Committee on Cancer staging for rectal cancer

SQLI

Stoma quality of life index

CQOLC

Caregiver quality of life index-cancer

BMI

Body mass index

ASA

American Society of Anesthesiologists

Notes

Conflicts of interest

None.

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Nino Gullà
    • 1
  • Stefano Trastulli
    • 1
    • 4
  • Carlo Boselli
    • 1
  • Roberto Cirocchi
    • 1
  • Davide Cavaliere
    • 2
  • Giorgio Maria Verdecchia
    • 2
  • Umberto Morelli
    • 3
  • Daniele Gentile
    • 1
  • Emilio Eugeni
    • 1
  • Daniela Caracappa
    • 1
  • Chiara Listorti
    • 1
  • Francesco Sciannameo
    • 1
  • Giuseppe Noya
    • 1
  1. 1.Department of General and Oncologic SurgeryUniversity of PerugiaPerugiaItaly
  2. 2.Unit of Surgery and Advanced Oncology Therapies, Forlì HospitalForlìItaly
  3. 3.Academic Surgery DepartmentRoyal London HospitalLondonUK
  4. 4.Department of General SurgeryUniversity of Perugia, St. Maria HospitalTerniItaly

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