title: Ghost ileostomy after anterior resection for rectal cancer: a preliminary experience.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy.
authors.forename: Nino
authors.initials: N
authors.lastname: Gullà
authors.forename: Stefano
authors.initials: S
authors.lastname: Trastulli
authors.forename: Carlo
authors.initials: C
authors.lastname: Boselli
authors.forename: Roberto
authors.initials: R
authors.lastname: Cirocchi
authors.forename: Davide
authors.initials: D
authors.lastname: Cavaliere
authors.forename: Giorgio Maria
authors.initials: GM
authors.lastname: Verdecchia
authors.forename: Umberto
authors.initials: U
authors.lastname: Morelli
authors.forename: Daniele
authors.initials: D
authors.lastname: Gentile
authors.forename: Emilio
authors.initials: E
authors.lastname: Eugeni
authors.forename: Daniela
authors.initials: D
authors.lastname: Caracappa
authors.forename: Chiara
authors.initials: C
authors.lastname: Listorti
authors.forename: Francesco
authors.initials: F
authors.lastname: Sciannameo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Noya
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D015331:Cohort Studies; D003082:Colectomy / Q000379:methods*; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007081:Ileostomy / Q000009:adverse effects / Q000379:methods*; D007813:Laparotomy / Q000379:methods; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010149:Postoperative Pain / Q000503:physiopathology; D011183:Postoperative Complications / Q000503:physiopathology / Q000628:therapy; D011446:Prospective Studies; D011788:Quality of Life; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012007:Rectum / Q000601:surgery; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D013524:Surgical Flaps; D054047:Surgical Stomas; D013536:Suture Techniques; D016896:Treatment Outcome