title: Temporary percutaneous ileostomy versus conventional loop ileostomy in mechanical extraperitoneal colorectal anastomosis: a retrospective study.
abstract: OBJECTIVE
  Loop ileostomy is a suitable procedure for transitory faecal diversion after low colorectal anastomosis, but it causes relevant morbidities (discomfort, peristomal infections, dehydration) and requires a second operation to be closed. We already described an alternative technique of temporary percutaneous ileostomy (TPI) that can be removed without surgery.
  
  
  METHODS
  The data of 143 consecutive patients, undergoing elective laparoscopic anterior resection of the rectum for adenocarcinoma and low mechanical colorectal anastomosis, 68 with conventional loop ileostomy (CLI) and 75 with TPI, were analyzed.
  
  
  RESULTS
  Neither intra-operative complications nor deaths occurred during the follow-up period. Clinical anastomotic leakage occurred in 4 patients with CLI and in 1 with TPI (p = 0.191). The median time required for the emission of gases and faeces through the stoma was respectively 1 and 2.5 days in the CLI group, and 1 and 2 days in the TPI group (p = 0.259 and p = 0.126). The median post-operative stay was 8 days in the CLI group and 11 days in the TPI group (p < 0.001). PTIs were removed on the median of 9 days after surgery without major complications, whereas the CLIs were re-canalized in 79.4% of patients on an average of 106 days, with 2 major complications.
  
  
  CONCLUSIONS
  The temporary percutaneous ileostomy seems to be a valid alternative to conventional ileostomy, ensuring optimal faecal diversion and less patient discomfort. It can be easily removed without surgery, allowing patients a better outcome.
authors.affiliation: University of Perugia, School of Medicine, Department of Surgery, Via G. Dottori, 06132 Perugia, Italy. rondellif@hotmail.com
authors.forename: F
authors.initials: F
authors.lastname: Rondelli
authors.forename: R
authors.initials: R
authors.lastname: Balzarotti
authors.forename: W
authors.initials: W
authors.lastname: Bugiantella
authors.forename: L
authors.initials: L
authors.lastname: Mariani
authors.forename: R
authors.initials: R
authors.lastname: Pugliese
authors.forename: E
authors.initials: E
authors.lastname: Mariani
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D057868:Anastomotic Leak; D003106:Colon / Q000601:surgery; D015179:Colorectal Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D007081:Ileostomy / Q000379:methods*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012007:Rectum / Q000601:surgery