title: [Ileostomy versus colostomy: which is preferable?]
abstract: OBJECTIVE
  To investigate whether an ileostomy or colostomy should be preferred in patients requiring temporary double-barrel stoma construction and in whom it is technically possible to construct both types.
  
  
  METHODS
  Systematic literature search and retrospective comparative analysis.
  
  
  METHODS
  PubMed, Embase and the Cochrane Library were searched for all literature comparing loop ileostomy and loop colostomy. In addition, we retrospectively analysed 361 patients who had received a loop ileostomy or loop colostomy designed to be temporary between 2009 and 2015 in our hospital, Meander Medisch Centrum, Amersfoort, the Netherlands. Outcome measures were: quality of life, short-term and long-term complications.
  
  
  RESULTS
  The literature search yielded 2092 studies, of which eight were ultimately included. Ileostomy was the preferred stoma in the overall conclusion of six of these studies; no preference was given in the other two. In addition, we analyzed 361 patients from our own hospital in whom a temporary deviating stoma was constructed. 49.6% (n = 179) had a colostomy constructed, the other 50.4% (n = 182) an ileostomy. Significantly fewer stoma retractions (p < 0.01) and incisional hernias (p < 0.01) were reported in the loop ileostomy group. Patients with an ileostomy, however, more often presented with a high-output stoma (p < 0.01) resulting in dehydration (p = 0.03).
  
  
  CONCLUSIONS
  A loop ileostomy has a number of advantages over a colostomy. However, in patients with an increased risk of dehydration or compromised renal function, colostomy construction should be seriously considered given the higher complication risk if a high-output stoma develops.
authors.affiliation: Meander Medisch Centrum, afd. Heelkunde, Amersfoort.
authors.forename: F J
authors.initials: FJ
authors.lastname: Amelung
authors.forename: C P D
authors.initials: CP
authors.lastname: Van 't Hullenaar
authors.forename: P M
authors.initials: PM
authors.lastname: Verheijen
authors.forename: E C J
authors.initials: EC
authors.lastname: Consten
mesh_terms: D000714:Anastomosis, Surgical; D003106:Colon / Q000601:surgery; D003125:Colostomy / Q000379:methods; D019299:Decompression, Surgical / Q000379:methods*; D006801:Humans; D007081:Ileostomy / Q000379:methods; D009426:Netherlands; D011183:Postoperative Complications; D011788:Quality of Life; D012007:Rectum / Q000601:surgery; D012189:Retrospective Studies