Proctocolectomy and pelvic pouch – Is a diverting stoma dangerous for the patient?

Abstract

The proportion of complications associated with diverting loop ileostomies in pelvic pouch surgery was considerable. A randomised controlled multicentre study is ethically defensible and is recommended.

Morbidity related to defunctioning loop ileostomy in low anterior resection

“…Previous morbidity studies have often included patients with inflammatory bowel disease and patients not subjected to total mesorectal excision (TME) surgery [14,15]. Furthermore, the defunctioning procedure has not been performed as a standard procedure, thus implicating a selection bias [10,11,15].…”

Proximal Diversion at the Time of Ileal Pouch-Anal Anastomosis for Ulcerative Colitis

“…25 Bowel obstruction has been reported to occur in 6.4 to 15 percent of patients after loop ileostomy closure, and 25 to 45 percent of these patients require surgery. 24,25 Patients who have a loop ileostomy created at the time of IPAA are at an increased risk of both early and late postoperative small-bowel obstruction compared with patients who did not have a loop ileostomy. 26 Creation of a loop ileostomy at the time of IPAA is also associated with an increased overall length of stay in hospital and increased treatment costs as compared with IPAA without an ileostomy.…”

Rod in loop ileostomy: just an insignificant detail for ileostomy-related complications?

“…On the other hand, a large variety of complications from the ileostomy itself are described in the literature [7,8]. They include suboptimal stoma site, stoma necrosis, retraction, stenosis, prolapse, peristomal hernia, peristomal dermatitis, peristomal fistula, peristomal sepsis, small bowel obstruction, and dehydration [9,10].…”