title: Comparison of Transumbilical and Conventional Defunctioning Ileostomy in Laparoscopic Anterior Resections for Rectal Cancer.
abstract: OBJECTIVE
  Laparoscopic surgery has made possible anterior resections with small incisions suitable for creating stomas. We retrospectively compared surgical results and stomal complications between transumbilical defunctioning ileostomy (TDI) and conventional defunctioning ileostomy (CDI) in laparoscopic anterior resections for rectal cancer.
  
  
  METHODS
  We compared patients who underwent laparoscopic anterior resection with TDI (n=47) with those undergoing CDI (n=27) for rectal cancer between February 2011 and January 2015.
  
  
  RESULTS
  For the initial operations, the TDI group had significantly less intraoperative blood loss (30.3 ml vs. 117.0 ml; p=0.014). For stomal closure, the TDI group experienced significantly fewer wound infections (2 vs. 8 cases; p=0.002) and bowel obstructions (none vs. 3 cases; p=0.039). No significant differences in stomal complication rates were observed.
  
  
  CONCLUSIONS
  TDI is associated with better surgical results and fewer complications than CDI after laparoscopic anterior resection for rectal cancer.
authors.affiliation: Department of Surgery, Jikei University School of Medicine, Tokyo, Japan etoken@jikei.ac.jp.
authors.forename: Ken
authors.initials: K
authors.lastname: Eto
authors.affiliation: Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Kosuge
authors.affiliation: Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Masahisa
authors.initials: M
authors.lastname: Ohkuma
authors.affiliation: Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Haruki
authors.affiliation: Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Kai
authors.initials: K
authors.lastname: Neki
authors.affiliation: Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Mitsumori
authors.affiliation: Department of Plastic Surgery, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Ishida
authors.affiliation: Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Yanaga
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007081:Ileostomy / Q000379:methods; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000601:surgery*; D016896:Treatment Outcome; D014472:Umbilicus / Q000601:surgery
keywords: Defunctioning ileostomy; laparoscopic surgery; low anterior resection