Investigation of Mortality and Morbidity In Patients Associated With Low Anterior Resection and Ghost Ileostomy

Abstract

Background: Ghost ileostomy is a newly invented method that is used in patients with low anterior resection and colorectal anastomosis. Ghost ileostomy can be used instead of a converting stoma. A converting stoma (CS) is critical after low rectal resection procedures due to its role in preventing anastomosis leakage, especially in patients who are at higher risk, but its complications are non-negligible. The authors approached a study of Ghost ileostomy to identify its probable post-operation morbidity and mortality. The purpose of this study was to assess the prevalence of some post-operation morbidity such as anastomosis bleeding or hematoma, prolonged ileus, pulmonary embolism, intra-abdominal abscess, wound site infection, and other complications. Methods: 26 patients with low anterior resection and colorectal anastomosis due to colon cancer without any risk factor between 2013 and 2014 were selected. Checking of anastomosis leakage after 10-14 days post-operation was analyzed to assess the prevalence of anastomosis leakage and compare post-operation morbidity and mortality. Results: The mean age of cases was 55 years (40 to 65). 16 (61.5%) were male and 10 (38.5%) females. The average BMI is 23.7 and all of the patients are in the normal range. The authors’ mortality rate was negative. 2 patients (0.076%) suffered from prolonged ileus and one patient (0.038%) had a wound site infection. Other postoperation morbidities such as anastomosis bleeding or hematoma, pulmonary embolism, intra-abdominal abscess were negative. The authors had no stoma-related morbidity and also no anastomosis morbidity. Conclusions: Anastomosis leakage is the most common complication in colorectal surgeries. Diverting stoma can decrease complications of anastomosis leakage but there is no evidence of its preventing role. By using ghost ileostomy, the authors can manage selective loop ileostomy and the complications will be reduced. The most reliable way for anastomosis leakage diagnosis is the surgeon’s suspicion. Converting stoma that is used for preventing anastomosis leakage, has significant complications of its own. As the anastomosis leakage does not have a high prevalence, the authors can use ghost ileostomy to reduce the complications and improve the quality of life.