Ghost Ileostomy with or without abdominal parietal split.

Area of Science:

• Colorectal Surgery
• Surgical Oncology
• Gastroenterology

Background:

• Covering stomas (CS) after low anterior rectal resection are associated with complications, prolonged recovery, and reduced quality of life.
• Ghost Ileostomy (GI) allows for stoma creation only if anastomotic leakage is clinically evident, avoiding unnecessary procedures.
• GI offers comparable mortality and morbidity to classic covering stomas in cases requiring delayed stoma opening, with potential economic benefits.

Purpose of the Study:

• To evaluate the safety and efficacy of Ghost Ileostomy (GI) in patients undergoing anterior extra-peritoneal rectum resection.
• To compare outcomes of GI fashioned with or without abdominal parietal split.

Main Methods:

• Prospective analysis of 20 patients undergoing anterior extra-peritoneal rectum resection for rectal carcinoma with TME.
• Fashioning of GI with or without abdominal parietal split.

Main Results:

• In patients with GI without split laparotomy: no mortality, one anastomotic leak.
• In patients with GI with split laparotomy: one death, one infection, one respiratory complication.
• Clinical follow-up was 12 months.

Conclusions:

• Techniques for GI fashioning showed no significant differences when performed by expert surgeons.
• Further randomized trials are needed to provide more evidence supporting clinical observations.