Document Detail


Ileostomy or colostomy for temporary decompression of colorectal anastomosis. Systematic review and meta-analysis.
MedLine Citation:
PMID:  18553003     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The controversy regarding whether loop ileostomy or loop transverse colostomy is a better method for temporary decompression of colorectal anastomosis motivated this review. METHODS: Five randomized trials were included, with 334 patients: 168 in the loop ileostomy group and 166 in the loop transverse colostomy group. The outcomes analyzed were: 1. Mortality; 2. Wound infection; 3. Time of stoma formation; 4. Time of stoma closure; 5. Time interval between stoma formation and closure; 6. Stoma prolapse; 7. Stoma retraction; 8. Parastomal hernia; 9. Parastomal fistula; 10. Stenosis; 11. Necrosis; 12. Skin irritation; 13. Ileus; 14. Bowel leakage; 15. Reoperation; 16. Patient adaptation; 17. Length of hospital stay; 18. Colorectal anastomotic dehiscence; 19. Incisional hernia; 20. Postoperative bowel obstruction. RESULTS: Stoma prolapse was statistically significant (p = 0.00001), but with statistical heterogeneity; the sensitive analysis was applied, excluding the trials that included emergency surgery, and this showed: p = 0.02, with I2 = 0% for the heterogeneity test. CONCLUSIONS: The outcomes reported were not statistically or clinically significant except for stoma prolapse. Better evidence for making the choice between loop ileostomy or loop colostomy requires large-scale randomized controlled trials.
Authors:
Katia Ferreira Güenaga; Suzana Angélica Silva Lustosa; Sarhan Sydney Saad; Humberto Saconato; Delcio Matos
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Acta cirúrgica brasileira / Sociedade Brasileira para Desenvolvimento Pesquisa em Cirurgia     Volume:  23     ISSN:  0102-8650     ISO Abbreviation:  Acta Cir Bras     Publication Date:    2008 May-Jun
Date Detail:
Created Date:  2008-06-16     Completed Date:  2009-07-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9103983     Medline TA:  Acta Cir Bras     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  294-303     Citation Subset:  IM    
Affiliation:
Division of Gastroenterology, Metropolitana University, Santos, SP, Brazil. kfg012@terra.com.br
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MeSH Terms
Descriptor/Qualifier:
Anastomosis, Surgical
Colostomy / standards*
Decompression, Surgical / methods*
Humans
Ileostomy / standards*
Randomized Controlled Trials as Topic
Sensitivity and Specificity
Surgical Stomas / pathology
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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