title: Meta-analysis of temporary ileostomy versus colostomy for colorectal anastomoses.
abstract: OBJECTIVE
  Defunctioning stoma is a common surgical procedure, it is now generally acknowledged that defunctioning stoma significantly reduce the rates of complications in colorectal surgery, but the choice of temporary ileostomy or temporary colostomy for defunctioning colorectal anastomoses remains controversial. This meta-analysis evaluated two types of defunctioning stoma to determine whether one is superior to the other.
  
  
  METHODS
  Studies and relevant literatures comparing temporary ileostomy with temporary colostomy for defunctioning colorectal anastomoses were searched though PubMed, Embase and The Cochrane Library. The rates of complications were pooled and compared using a meta-analysis. The risk ratios were calculated with 95% confidence intervals to evaluate the safety and efficacy of each technique.
  
  
  RESULTS
  Five randomized controlled trials and seven non-randomized studies were included, with 1687 patients in total. The meta-analysis of the RCTs demonstrated a lower risk of stoma prolapse (RR 0.15; 95% CI: 0.04-0.48, p = 0.001) in the temporary ileostomy group. Meta-analysis of the non-randomized studies showed a lower risk of stoma prolapse (RR 0.26; 95% CI 0.10-0.67, p = 0.005) and wound infection after stoma closure (RR 0.28; 95% CI 0.5-0.52, p < 0.0001) in the temporary ileostomy group. No other statistically significant difference was observed for complications.
  
  
  CONCLUSIONS
  Each type of defunctioning stoma has its advantages and disadvantages, and there is not a strong evidence for the superiority of one temporary stoma over another for colorectal anastomoses. According to this, large scale RCTs and high quality studies are needed to conduct.
authors.affiliation: Department of Gastrointestinal Surgery, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu Province, China.
authors.forename: J
authors.initials: J
authors.lastname: Chen
authors.forename: D R
authors.initials: DR
authors.lastname: Wang
authors.forename: J R
authors.initials: JR
authors.lastname: Zhang
authors.forename: P
authors.initials: P
authors.lastname: Li
authors.forename: G
authors.initials: G
authors.lastname: Niu
authors.forename: Q
authors.initials: Q
authors.lastname: Lu
mesh_terms: D000714:Anastomosis, Surgical; D003106:Colon / Q000601:surgery*; D003125:Colostomy; D019299:Decompression, Surgical / Q000379:methods*; D006801:Humans; D007081:Ileostomy; D012007:Rectum / Q000601:surgery*