Midline Stoma via the Umbilicus Versus Traditional Diverting Loop Ileostomy: a Retrospective Comparative Study
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Diverting loop ileostomies have traditionally been fashioned in the right iliac fossa, but recently, a novel technique of midline loop ileostomy at the umbilical port site during laparoscopic colorectal surgery has been described. We aim to compare outcomes after creation and reversal of these two types of ileostomy. Using a retrospective study design, 10 consecutive patients who underwent a midline loop ileostomy were compared with 10 consecutive patients who underwent a traditional right iliac fossa stoma. Baseline characteristics, operating time, length of stay and complications for the initial operation as well as reversal of stoma operation were compared between the two groups. There was no significant difference in duration of operation or complication rate after the initial stoma formation, but length of hospital stay was longer in the traditional stoma group (10 vs 4.5 days, p = 0.04). After reversal of ileostomy, the traditional stoma group had a significantly higher perioperative complication rate compared to the midline stoma group (50 vs 0%, p = 0.03), but there was no difference in operation time or length of hospital stay. Midline diverting loop ileostomy is a safe technique with regard to formation, management and reversal when compared to a traditional right iliac fossa loop ileostomy. It is a potentially attractive alternative in the era of laparoscopic colorectal surgery. A randomised controlled trial is recommended.
KeywordsUmbilical stoma Ileostomy Laparoscopic colorectal surgery Diverting stoma Faecal diversion
Compliance with Ethical Standards
Ethics approval from the Eastern Health Human Research Ethics Committee was obtained prior to study commencement.
Conflict of Interest
The authors declare that they have no conflict of interest.
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