[Protective ileostoma versus protective transverse stoma. What evidence is available?]

The clinical outcome of anastomotic leakage in colorectal and coloanal anastomoses necessitates a loop stoma for fecal diversion. Controversy remains of the most suitable position of the stoma. In this respect a loop ileostomy or loop colostomy can be performed. The aim of this study was to determine the advantages and disadvantages of both surgical strategies from the literature and to derive possible recommendations. Both methods provide a good operative outcome with low complication rates. Overall there is a trend towards ileostomy because of lower complication rates after stoma creation and the incidence of sepsis and stoma prolapse in particular is significantly reduced after ileostomy. Concerning stoma reversal both methods seem to be equivalent. As long as no large evidenced-based, randomized studies are available loop ileostomy seems to be the most appropriate surgical procedure.