 |
|
Temporary Transverse Colostomy vs Loop Ileostomy in Diversion
A Case-Matched Study
Yasuo Sakai, MD,PhD;
Heidi Nelson, MD;
Dirk Larson;
Laurie Maidl, RN;
Tonia Young-Fadok, MD,MS;
Duane Ilstrup
Arch Surg. 2001;136:338-342.
Hypothesis For temporary fecal diversion, transverse colostomy (TC) has superior safety, but loop ileostomy (LI) has superior management qualities.
Methods Of patients with TC or LI seen between 1988 and 1997, 63 patients were matched for diagnosis, operative procedure, and date of surgery. The 2 groups were then compared for hospital/postoperative mortality and morbidity and stoma complications.
Results Mortality rates were 6.3% for the TC group and 1.6% for the LI group (P = .25). Morbidity rates for stoma creation and for stoma closure were 47.6% and 10% (P = .19), respectively, for the TC group, and 36.5% and 6.3% (P>.99), respectively, for the LI group. Most morbidity events were minor, and neither procedure-related nor other medical complications showed a significant difference between the groups. However, patients with a TC were significantly more likely to experience skin trouble around the stoma (TC vs LI, 15.9% vs 3.2%) and leakage around the stoma (TC vs LI, 12.7% vs 1.6%).
Conclusions Regarding safety, TC and LI should be considered equivalent options for temporary fecal diversion. We recommend further study comparing the 2 procedures with regard to patient perception and quality of life.
From the Division of Colon and Rectal Surgery (Drs Sakai, Nelson, and Young-Fadok and Ms Maidl); the Section of Biostatistics (Messrs Larson and Ilstrup), Mayo Clinic and Mayo Foundation; Rochester, Minn; and the Department of Surgery, Niigata University School of Medicine, Niigata, Japan (Dr Sakai).
|
