| Ileostomy or colostomy for temporary decompression of colorectal anastomosis. Systematic review and meta-analysis. | |
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MedLine Citation:
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PMID: 18553003 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Katia Ferreira Güenaga; Suzana Angélica Silva Lustosa; Sarhan Sydney Saad; Humberto Saconato; Delcio Matos |
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Publication Detail:
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Type: Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
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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:
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Created Date: 2008-06-16 Completed Date: 2009-07-16 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9103983 Medline TA: Acta Cir Bras Country: Brazil |
Other Details:
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Languages: eng Pagination: 294-303 Citation Subset: IM |
Affiliation:
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Division of Gastroenterology, Metropolitana University, Santos, SP, Brazil. kfg012@terra.com.br |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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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