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Is a bridge (rod) necessary for loop ileostomy? A phase II randomized control trial.

C Sabbagh1,2, F Mauvais3, M Demouron3

  • 1Department of Digestive Surgery, Amiens University Medical Center, Amiens, France.

Techniques in Coloproctology
|March 25, 2025
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Summary

Using a bridge in loop ileostomies does not reduce stomal complications or improve patient quality of life. This study found no significant difference in morbidity rates between patients with and without an ileostomy bridge.

Keywords:
BridgeDivertionQuality of lifeStoma

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Area of Science:

  • Colorectal Surgery
  • Surgical Innovation
  • Patient Outcomes

Background:

  • The clinical utility of a bridge in loop ileostomies remains a subject of debate.
  • This study investigates whether employing a bridge during loop ileostomy creation can mitigate postoperative morbidity.

Purpose of the Study:

  • To evaluate the efficacy of using a bridge in loop ileostomies for reducing stomal complications.
  • To assess the impact of an ileostomy bridge on patient quality of life.

Main Methods:

  • A multicenter phase 2 randomized superiority trial involving patients undergoing elective colorectal surgery.
  • Patients were randomized into a bridge group or a no-bridge group.
  • Primary endpoint: absence of postoperative stomal complications at 2 months; secondary endpoints: morbidity at 1 month and STOMA-QOL score at 2 months.

Main Results:

  • A total of 130 patients were randomized (67 bridge, 63 no-bridge).
  • The stomal complication-free rate was 76% (bridge) vs. 67% (no-bridge) (p=0.3).
  • No significant differences were observed in complication distribution or STOMA-QOL scores between groups.

Conclusions:

  • The use of a bridge in loop ileostomies does not appear to reduce the rate of stomal complications.
  • Employing an ileostomy bridge did not negatively impact patients' quality of life.