Evidence - Ileostomy, construction of - general and visceral surgery
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Literature summary
- When constructing temporary stomas, the complication rate for ileostomies is less than for colostomies.
In patients with colorectal cancer undergoing elective surgery, the complication rate of generalized infections and wound infections is less in ileostomy than colostomy, but the reverse is true in stoma closure.
So far there is no convincing evidence as to whether patients undergoing colorectal surgery fare better with an ileostomy rather than colostomy. The answer to this question requires randomized controlled trials. - In LAR (low anterior [rectal] resection), most surgeons prefer an ileostomy, since both construction and closure are generally easier, even if colostomy supposedly benefits from less complications with intestinal obstructions and ileus.
- In acute emergency surgery, there is no significant difference in the complication rate between ileostomy and colostomy. However, the complications after ileostomy appear to be more serious than following colostomy.
- This analysis comprised 12 comparative studies between 2007 and 2009 totaling 1529 patients. The overall risk of sepsis and stomal prolapse, peristomal hernia, stricture and stomal retraction, necrosis, and hemorrhage in stoma construction was lower in ileostomy than in colostomy. In contrast, ileostomy has a higher complication rate for dehydration and stoma closure.
- When constructing temporary stomas, the complication rate for ileostomies is less than for colostomies.
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