Novel self-reversing tube ileostomy as an alternative for conventional loop ileostomy for fecal diversion: A cohort tertiary care center study.

OBJECTIVE

Anastomotic leakage following colorectal anastomosis poses substantial morbidity and mortality. Defunctioning loop ileostomy has been employed as a preventive measure, but has its own complications, including its reversal. In light of these challenges, tube ileostomy has emerged as an alternative, seeking to fulfil the same purpose as loop ileostomy while minimising complications associated with stoma creation and reversal.

MATERIAL AND

METHODS

Conducted as a cohort study, a total of 88 patients were evenly distributed into two groups. Data collection spanned six months post-surgery or until the conclusion of the study period, with monthly follow-ups. Both types of ileostomy were performed in both elective and emergency settings.

RESULTS

In this study comparing tube and loop ileostomy, tube ileostomy showed several advantages: Lower output (218±19 mL vs. 333.33±58 mL), shorter hospital stay (8.3 vs. 11.32 days), fewer stoma bag needs, and faster closure without surgical reversal. Complications like skin excoriation, electrolyte imbalance, and hypertrophic scarring were significantly lower in tube ileostomy. Although tube-related issues like blockade (40.9%) and leakage (15.9%) occurred, overall, comorbidity handling and patient independence were better. Statistical analysis confirmed significant differences in key parameters, favouring tube ileostomy as a safer, simpler faecal diversion alternative.

CONCLUSION

In the early phases of this investigation, tube ileostomy demonstrated favourable outcomes. The observed reduction in complications, ease of management for tube ileostomy-related issues, and decreased hospitalisation and reversion surgery requirements highlight its potential advantages. Further exploration and long-term follow-up are warranted to validate these initial findings and ascertain the sustained efficacy and safety of tube ileostomy.