Anastomotic Leakage in Rectal Surgery: Role of the Ghost Ileostomy

A protective ileostomy performed during anterior resection in rectal surgery is considered a good practice to prevent anastomotic leakage. A derivative ostomy seems to be able to minimize the clinical consequences of an anastomotic leakage, but not to prevent it. The present study examined the role of the ghost ileostomy in anastomotic leakage following rectal surgery.

This study included 82 patients that had undergone anterior rectal resection. A total of 32 patients underwent ghost ileostomy (GH) and 50 patients underwent ileostomy (IL).

The incidence of anastomotic leakage was equal to 7.32%, occurring in 3 patients of the IL group (6%) and in 3 patients of the GH group (9.38%), in which the ghost was converted into derivative ileostomy. Therefore, 47 patients with IL (94%) underwent useless ileostomy implementation, and 29 patients (90.62%) with GH avoided ileostomy.

In this study no increase in morbidity and mortality rate was observed. Therefore, ghost ileostomy proved to be as safe as ileostomy in terms of outcome, morbidity and mortality.