title: Virtual ileostomy following rectal cancer surgery: a good tool to avoid unusefull stomas?
abstract: OBJECTIVE
  Anastomotic leak is a life threatening complication following surgery for rectal cancer below peritoneal reflection. Colostomy or ileostomy following colorectal or coloanal anastomosis protect the patients from general peritonitis or sepsis secondary to anastomotic leak.
  
  
  METHODS
  In this paper the experience of the last 100 cases of rectal cancer below the peritoneal reflection treated from 2004 to 2010 was reviewed.
  
  
  RESULTS
  In 79 cases, primary anastomosis was performed. In 44/79 cases virtual ileostomy was prepared and in 35/79 cases, based on risk factors and intraoperative decision of the surgeon, an open ileostomy was performed. In 8/44 cases virtual ileostomy was opened, thus avoiding in 35/79 cases a second operation.
  
  
  CONCLUSIONS
  The goal for a good clinical outcome of patients with virtual ileostomy is a strict postoperative follow-up focused on fever onset and quality of drainage discharge. In our experience virtual ileostomy is a good tool to avoid open ostomy at time of primary colorectal or coloanal anastomosis in a good number of cases.
authors.affiliation: Santa Maria Goretti Hospital, Rome, Italy. msacchi@adiurg.com
authors.forename: Marco
authors.initials: M
authors.lastname: Sacchi
authors.forename: Pietro
authors.initials: P
authors.lastname: Picozzi
authors.forename: Pietro
authors.initials: P
authors.lastname: Di Legge
authors.forename: Loreto
authors.initials: L
authors.lastname: Capuano
authors.forename: Luigi
authors.initials: L
authors.lastname: Greco
authors.forename: Matteo
authors.initials: M
authors.lastname: De Stefano
authors.forename: Sara
authors.initials: S
authors.lastname: Nicodemi
authors.forename: Maria Carlotta
authors.initials: MC
authors.lastname: Sacchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D057868:Anastomotic Leak / Q000517:prevention & control*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007081:Ileostomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D012004:Rectal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D012307:Risk Factors; D016896:Treatment Outcome