Ghost ileostomy: real and potential advantages

Miccini, Michelangelo; Bonapasta, Stefano Amore; Gregori, Matteo; P, Barillari; Tocchi, A

doi:10.1016/j.amjsurg.2009.12.017

Cited by 39 publications

(34 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Some authors advocate a technique called ghost ileostomy, in which the small bowel loop is exteriorized and, in case of the anastomotic leakage, the ileostomy is opened, becoming a fully functional ostomy [26,27]. In case of no evidence of complications, the bowel loop is repositioned into the peritoneal cavity; thus no additional anastomosis is needed [26,27]. In our unit we create defunctioning ileostomy routinely, since most of our patients undergo neoadjuvant chemoradiotherapy.…”

Section: Discussionmentioning

confidence: 99%

Investigating Risk Factors for Complications after Ileostomy Reversal in Low Anterior Rectal Resection Patients: An Observational Study

Rubinkiewicz

Witowski

Wysocki

et al. 2019

JCM

View full text Add to dashboard Cite

Introduction: Defunctioning ileostomy has been widely used in patients undergoing low anterior rectal resection to reduce the rate of postoperative leakage. It is still not clear whether interval between primary procedure and ileostomy reversal has an impact on treatment outcomes. Methods: In our prospective observational study we reviewed 164 consecutive cases of patients who underwent total mesorectal excision with primary anastomosis. Univariate and multivariate regression models were used to search for risk factors for prolonged length of stay and complications after defunctioning ileostomy reversal. Receiver operating characteristic curves were utilized to set cut-off points for prolonged length of stay and perioperative morbidity. Results: In total, 132 patients were included in the statistical analysis. The median interval between primary procedure and defunctioning ileostomy reversal was 134 (range: 17–754) days, while median length of stay was 5 days (4–6 interquartile range (IQR)). Prolonged length of stay cut-off was established at 6 days. Regression models revealed that interval between primary surgery and stoma closure as well as complications after primary procedure are risk factors for complications after defunctioning ileostomy reversal. Prolonged length of stay has been found to be related primarily to interval between primary surgery and stoma closure. Conclusions: In our study interval between primary surgery and stoma closure along with complication occurrence after primary procedure are risk factors for perioperative morbidity and prolonged length of stay (LOS) after ileostomy reversal. The effort should be made to minimize the interval to ileostomy reversal. However, randomized studies are necessary to avoid the bias which appears in this observational study and confirm our findings.

show abstract

Section: Discussionmentioning

confidence: 99%

Investigating Risk Factors for Complications after Ileostomy Reversal in Low Anterior Rectal Resection Patients: An Observational Study

Rubinkiewicz

Witowski

Wysocki

et al. 2019

JCM

View full text Add to dashboard Cite

show abstract

“…The technique of pre‐stage ileostomy, also known as ‘ghost’ ileostomy, has been described whereby a terminal ileal loop is exteriorized through the abdominal wall but is left unopened . Should a complication of the anastomosis develop it can be rapidly transformed into a definitive ileostomy under local anaesthesia.…”

Section: Defunctioning Stomamentioning

confidence: 99%

A collaborative review of the current concepts and challenges of anastomotic leaks in colorectal surgery

et al. 2017

View full text Add to dashboard Cite

The reduction of the incidence, detection and treatment of anastomotic leakage (AL) continues to challenge the colorectal surgical community. AL is not consistently defined and reported in clinical studies, its occurrence is variably reported and its impact on longterm morbidity and health-care resources has received relatively little attention. Controversy continues regarding the best strategies to reduce the risk. Diagnostic tests lack sensitivity and specificity, resulting in delayed diagnosis and increased morbidity. Intra-operative fluorescence angiography has recently been introduced as a means of real-time assessment of anastomotic perfusion and preliminary evidence suggests that it may reduce the rate of AL. In addition, concepts are emerging about the role of the rectal mucosal microbiome in AL and the possible role of new prophylactic therapies. In January 2016 a meeting of expert colorectal surgeons and pathologists was held in London, UK, to identify the ongoing controversies surrounding AL in colorectal surgery. The outcome of the meeting is presented in the form of research challenges that need to be addressed.

show abstract

“…For the first time, to our knowledge, our study describes and evaluates the feasibility and efficacy of a new technique of pre-stage ileostomy, called ghost ileostomy (GI) [14], in terms of management of the anastomotic leakage. An intestinal loop of the terminal ileum is identified with a vascular vessel loop, which is exteriorized through the abdominal wall without tension and then fixed to cutaneous surface.…”

Section: Introductionmentioning

confidence: 99%

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

Gullà

Trastulli

Boselli

et al. 2011

Langenbecks Arch Surg

View full text Add to dashboard Cite

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.

show abstract

Ghost ileostomy: real and potential advantages

Cited by 39 publications

References 11 publications

Investigating Risk Factors for Complications after Ileostomy Reversal in Low Anterior Rectal Resection Patients: An Observational Study

Investigating Risk Factors for Complications after Ileostomy Reversal in Low Anterior Rectal Resection Patients: An Observational Study

A collaborative review of the current concepts and challenges of anastomotic leaks in colorectal surgery

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

Contact Info

Product

Resources

About