Temporary Fistula For Rectal Cancer Surgery: The Choice Of Terminal Ileostomy And Transverse Colostomy

Objectives:The aim of this study was to determine the outcome of loop transverse colostomy compared to loop ileostomy as a temporary defunctioning stoma following rectal cancer surgery.Methods:Data of 139 patients between 2014 and 2016 were analyzed in this two-center study to determine the surgical outcome in patients with loop colostomy(n=25)in comparison to loop ileostomy(n= 114)for fecal diversion including lengthof stay and complication rates during stoma creation and stoma reversal.Results:During stoma placement,Stoma prolapse and parastomal hernia occurred more often in the loop transverse colostomy group than in the loop ileostomy group(36% vs.4% and 36% vs.2%).During stoma reversal,wound infection occurred significantly more often in the loop transverse colostomy group than in the loop ileostomy group(32% vs.4%).Time to first defecation was significantly shorter in the loop ileostomy group after both placement and reversal(1.99 vs.4.88 and 2.32 vs.5.00).Hospital stay was significantly shorter in the loop ileostomy group than in the loop transverse colostomy group both placement and reversal(10.95 vs.18.36 and 9.61 vs.16.64).Conclusions:Both methods provide a good operative outcome to prevent anastomotic fistula.We do recommend the loop ileostomy in all patients wound infection rate is lower and hospital stay is shorter during stoma placement and stoma reversal.