Ileostoma as a promising tool in pathophysiological study and clinical intervention: a review from bench to beside

Ileostomy is extensively utilized as a preventive method to avert anastomotic leakage and other severe complications in colorectal surgery, serving as a valuable model for both study and clinical applications. The ileostoma, as a window, allows for the observation of a range of pathophysiological changes of complications in the mucosal layer of the defunctioned ileum, as well as in the defunctioned colon. It is precisely the changes in the intestinal microecology caused by ileostomy that may affect the efficacy of anti-tumor immunotherapy. Various interventions exist to flush the defunctioned intestine via the window, aiming to mitigate both short-term and long-term complications. These interventions include the use of normal saline, short-chain fatty acids, autologous intestinal fluid, and probiotics. Furthermore, there is a growing perspective advocating for the early closure (EC) of the ileostomy as a potentially superior management strategy. Moving forward, continued exploration of the window promises to yield further benefits for patients.