Comparative Outcomes of Loop Ileostomy and Loop Transverse Colostomy Following Curative Resection for Rectal Cancer

Temporary diversion of the fecal stream with a loop stoma is commonly performed to safeguard against an anastomotic failure and cause further complications. Commonly used stomas include loop ileostomy (LI) and loop transverse colostomy (LTC). Both of these techniques have their own complication profiles. This study highlights the comparison of patient outcomes and quality of life in these two stoma groups following curative resection for rectal cancer.

This randomized comparative study was carried out in the Colorectal Surgery Unit of Alexandria University Hospitals, Alexandria, Egypt, from February 2020 to February 2021 in patients undergoing curative resection for rectal cancer. Forty adult patients were enrolled and randomized (1:1) to undergo either LI or LTC. The 36-item short-form survey questionnaire was used to assess the quality of life. The statistical analysis of the collected data was done using IBM SPSS Statistics, Windows version 27.0, IBM Corp., Armonk, New York, USA.

LI was found to be significantly associated with shorter stoma creation, earlier output, and reduced hospital stay. However, LI had significantly higher 30-day complication rates, attributed mostly to dehydration and skin irritation. At 1 month, colostomy patients reported better quality of life and fewer pouch changes. Stoma reversal was quicker with ileostomy with comparable postoperative morbidity.

LI despite offering a faster construction and earlier recovery, carries the risk of early metabolic and skin complications. LTC, on the contrary, offers a better quality of life and fewer early complications, at the cost of a longer surgery. Thoughtful, patient-centered selection remains the cornerstone of optimal surgical practice.