title: Usefulness of ileostomy defunctioning stoma after anterior resection of rectum on prevention of anastomotic leakage A retrospective analysis.
abstract: OBJECTIVE
  Anastomotic leakage is one of the major complications occurring after anterior resection of rectum. A defunctioning stoma is usually created routinely or on surgeons' discretion. The aim of this study was to investigate the usefulness of temporary ileostomy to prevent anastomotic leakage comparing the postoperative course of patients with and without defunctioning loop ileostomy.
  
  
  METHODS
  Patients that underwent anterior resection of rectum were recruited. 140 patients were enrolled and divided in two groups: patients without and with defunctioning loop ileostomy. Patients' characteristics and other useful data were recorded. A comparison between the two groups was made. The minimum follow-up was 11 months.
  
  
  CONCLUSIONS
  18.6% of patients had a symptomatic anastomotic leakage. We observed more anastomotic leakages after medium-low resections of rectum with anastomosis than after resections with high anastomosis (15.7% vs 2.9%; p=0.03). There were no significant differences in overall and related mortality between patients without/with ileostomy. The presence of ileostomy was not protective towards anastomotic leakage either in the medium-low resections or in the high ones but it was towards its consequences such as clinical features. Nevertheless we found a statistically significative difference between recurrence rate of leakage in patients with and without ileostomy (p-Value=0.009).
  
  
  BACKGROUND
  Anterior resection of rectum, Ileostomy, Leakage.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Salamone
authors.forename: Leo
authors.initials: L
authors.lastname: Licari
authors.forename: Antonino
authors.initials: A
authors.lastname: Agrusa
authors.forename: Giorgio
authors.initials: G
authors.lastname: Romano
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Cocorullo
authors.forename: Nicolò
authors.initials: N
authors.lastname: Falco
authors.forename: Roberta
authors.initials: R
authors.lastname: Tutino
authors.forename: Gaspare
authors.initials: G
authors.lastname: Gulotta
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007081:Ileostomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors