title: Temporary Decompression in Critically Ill Patients: Retrospective Comparison of Ileostomy and Colostomy.
abstract: OBJECTIVE
  In critically ill patients, gastrointestinal function plays an important role in multiple organ dysfunction syndrome. Patients suffering from acute lower gastrointestinal dysfunction need to be performed a temporary fecal diversion after the failure of conservative treatment. This study aims to determine which type of fecal diversion is associated with better clinical outcomes in critically ill patients.
  
  
  METHODS
  Data of critically ill patients requiring surgical decompression following acute lower gastrointestinal dysfunction between January 2008 and June 2013 were retrospectively analyzed. Comparison was made between ileostomy group and colostomy group regarding the stoma-related complications and the recovery after stoma creation.
  
  
  RESULTS
  63 patients consisted of temporary ileostomy group (n = 35) and temporary colostomy group (n = 28) were included in this study. First bowel movement and length of enteral nutrition intolerance after fecal diversion were both significantly shorter in the ileostomy group than in the colostomy group (1.70 ± 0.95 vs. 3.04 ± 1.40; p < 0.001 and 3.96 ± 2.84 vs. 8.12 ± 7.05; p = 0.009). In comparison of the complication rates, we found a significantly higher incidence of dermatitis (31.43% vs. 7.14%; p = 0.017), hypokalemia (25.71 vs. 3.57; p = 0.017) and hypocalcemia (28.57 vs. 7.14; p = 0.031), and slightly lower incidence of stoma prolapse (0% vs. 10.71%; p = 0.082) in the ileostomy group than in the colostomy group.
  
  
  CONCLUSIONS
  Both procedures provide an effective defunctioning of the distant gastrointestinal tract with a low complication incidence. We prefer a temporary ileostomy to temporary colostomy for acute lower gastrointestinal dysfunction in critically ill patients.
authors.forename: Zhi-Liang
authors.initials: ZL
authors.lastname: Lin
authors.forename: Wen-Kui
authors.initials: WK
authors.lastname: Yu
authors.forename: Jia-Liang
authors.initials: JL
authors.lastname: Shi
authors.forename: Qi-Yi
authors.initials: QY
authors.lastname: Chen
authors.forename: Shan-Jun
authors.initials: SJ
authors.lastname: Tan
authors.forename: Ning
authors.initials: N
authors.lastname: Li
mesh_terms: D000328:Adult; D003125:Colostomy / Q000009:adverse effects; D016638:Critical Illness; D019299:Decompression, Surgical / Q000009:adverse effects / Q000379:methods*; D003672:Defecation; D004750:Enteral Nutrition; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007081:Ileostomy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D020127:Recovery of Function; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome