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Ghost ileostomy after anterior resection for rectal cancer: a preliminary experience

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Abstract

Purpose

The aim of this study was to describe and evaluate the feasibility and the eventual advantages of ghost ileostomy (GI) versus covering stoma (CS) in terms of complications, hospital stay and quality of life of patients and their caregivers after anterior resection for rectal cancer.

Methods

In this prospective study, we included patients who had rectal cancer treated with laparotomic anterior resection and confectioning a stoma (GI or CS), in the period comprised between January 2008 and January 2009. Short-term and long-term surgery-related mortality and morbidity after primary surgery (including that stoma-related and colorectal anastomosis-related) and consequent to the intervention of intestinal recanalization (CS group) and GI closure were evaluated. We evaluated hospital stay and quality of life of patients and their caregivers.

Results

Stoma-related morbidity rate was higher in the CS group than in GI group (37% vs. 5.5%, respectively, P = 0.04). Morbidity rate after intestinal recanalization in the CS group was 25.9% and 0% after GI closure (P = 0.08). Overall stoma morbidity rate was significantly lower in the GI group with respect to CS group (5.5% vs. 40.7%, respectively, P = 0.03). CS group was characterized by a significantly longer recovery time (P = 0.0002). Caregivers and stoma-related quality of life were better in the GI group than in CS group (P < 0.0001 and P = 0.0005, respectively).

Conclusions

GI is feasible, characterized by shorter recovery, lesser degree of total, as well as anastomosis-related morbidity and higher quality of life of patients and the caregivers in respect to CS. We suggest that GI (should be evaluated as an alternative to conventional ileostomy) could be indicated in selected patients that do not present risk factors, but require caution for anastomotic leakage for the low level of colorectal anastomosis.

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Abbreviations

CS:

Covering stoma

GI:

Ghost ileostomy

AJCC:

American Joint Committee on Cancer staging for rectal cancer

SQLI:

Stoma quality of life index

CQOLC:

Caregiver quality of life index-cancer

BMI:

Body mass index

ASA:

American Society of Anesthesiologists

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Authors and Affiliations

  1. Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy

    Nino Gullà, Stefano Trastulli, Carlo Boselli, Roberto Cirocchi, Daniele Gentile, Emilio Eugeni, Daniela Caracappa, Chiara Listorti, Francesco Sciannameo & Giuseppe Noya

  2. Unit of Surgery and Advanced Oncology Therapies, Forlì Hospital, Forlì, Italy

    Davide Cavaliere & Giorgio Maria Verdecchia

  3. Academic Surgery Department, Royal London Hospital, London, UK

    Umberto Morelli

  4. Department of General Surgery, University of Perugia, St. Maria Hospital, Via Tristano di Joannuccio, Terni, 05100, Italy

    Stefano Trastulli

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  1. Nino Gullà
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Correspondence to Stefano Trastulli.

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Gullà, N., Trastulli, S., Boselli, C. et al. Ghost ileostomy after anterior resection for rectal cancer: a preliminary experience. Langenbecks Arch Surg 396, 997–1007 (2011). https://doi.org/10.1007/s00423-011-0793-8

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  • DOI: https://doi.org/10.1007/s00423-011-0793-8

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