A COMPARATIVE STUDY ON THE OUTCOME OF ILEOSTOMY VERSUS COLOSTOMY FOR TEMPORARY DIVERSION OF RECTAL ANASTOMOSIS

HK HASSAN; S HUSSAIN; A SHABBIR; N AKHTAR; U RASHEED; S ULLAHA

doi:10.54112/bcsrj.v2024i1.1324

Authors

HK HASSAN Department of Surgical Nishtar Medical University/ Hospital Multan Pakistan
S HUSSAIN Department of Surgery Quai e Azam Medical College Bahawalpur Pakistan
A SHABBIR Department of Surgery Quai e Azam Medical College Bahawalpur Pakistan
N AKHTAR Department of Surgery Nishtar Medical University/ Hospital Multan Pakitan
U RASHEED Department of Anatomy Nishtar Medical University Multan Pakistan
S ULLAHA Department of Surgery Nishtar Medical University/ Hospital Multan Pakitan

DOI:

https://doi.org/10.54112/bcsrj.v2024i1.1324

Keywords:

Colostomy, Ileostomy, Ostomy, Rectal cancer

Abstract

Temporary diversion with a stoma is often required in patients undergoing rectal resection for rectal cancer to minimize anastomotic complications. Loop ileostomy and loop colostomy are the two common options for fecal diversion. Despite their widespread use, the comparative outcomes regarding morbidity and complications of these procedures, especially in the context of temporary diversion, remain debatable. Objective: To compare the outcomes of loop ileostomy and loop colostomy for temporary rectal diversion in cancer patients undergoing rectal resection. Methods: A prospective study was conducted in the General Surgery Department of Nishtar Hospital, Multan from June 2024 to November 2024. A total of 150 rectal cancer patients undergoing anterior resection were included in the study. Patients were divided into two groups; Group A included 75 patients undergoing loop ileostomy and Group B included 75 patients undergoing loop colostomy. The primary outcome was to perform a comparison between morbidity outcomes after stoma formation and closure between both procedures. Patients were followed up after every 2-4 weeks in OPD after stomal construction and reversal. Results: After stomal construction, the incidence of complications between both groups was similar. Overall morbidity occurred in 23 patients (30.6%) in group A and 21 patients (28%) in group B. The parastomal hernia was the most common complication in the study population in 31 patients (20.6%), the difference in both groups was insignificant (20% vs 21.3%) (p=0.78). After the stomal reversal, 4 (8%) in group A and 1 (1.9%) in group B had anastomotic leaks, however, the difference was insignificant (p=0.19). 50 (66.7%) patients in the ileostomy group and 51 (68%) patients in the colostomy group underwent stoma reversal. Complications after reversal were similar with the most common complication being wound infection (14 vs 7.9%) (p=0.53%). Conclusion: The outcomes of loop ileostomy and loop colostomy for temporary diversion of rectal anastomosis in patients with rectal cancer were comparable. Larger, randomized studies are needed to verify our findings.

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