Comparison of Transumbilical and Conventional Defunctioning Ileostomy in Laparoscopic Anterior Resections for Rectal Cancer

Abstract

Background/aim: Laparoscopic surgery has made possible anterior resections with small incisions suitable for creating stomas. We retrospectively compared surgical results and stomal complications between transumbilical defunctioning ileostomy (TDI) and conventional defunctioning ileostomy (CDI) in laparoscopic anterior resections for rectal cancer.

Patients and methods: We compared patients who underwent laparoscopic anterior resection with TDI (n=47) with those undergoing CDI (n=27) for rectal cancer between February 2011 and January 2015.

Results: For the initial operations, the TDI group had significantly less intraoperative blood loss (30.3 ml vs. 117.0 ml; p=0.014). For stomal closure, the TDI group experienced significantly fewer wound infections (2 vs. 8 cases; p=0.002) and bowel obstructions (none vs. 3 cases; p=0.039). No significant differences in stomal complication rates were observed.

Conclusion: TDI is associated with better surgical results and fewer complications than CDI after laparoscopic anterior resection for rectal cancer.

Keywords: Defunctioning ileostomy; laparoscopic surgery; low anterior resection.