Completely diverted tube ileostomy compared with loop ileostomy for protection of low colorectal anastomosis: a pilot study.

AIM: The study was designed to evaluate a new completely diverted tube ileostomy (CDTI) with a reversible single-row stapled occlusion of the distal limb to defunction a low colorectal anastomosis, and to compare it with a loop ileostomy (LI).

METHOD: From September 2010 to August 2012, 95 patients with rectal cancer who underwent elective low anterior resections were recruited into the study. They received either a CDTI or a LI. Demographics, clinical features and operative data were recorded.

RESULTS

Fifty-four patients (56%) had a CDTI and 41 (44%) a LI. There were no significant differences in patient demographics and clinical characteristics. Anastomotic dehiscence occurred in three (5.6%) patients in the CDTI group and two (4.9%) in the LI group (not significant) and no patient developed faecal peritonitis. In the CDTI group, the distal ileum spontaneously recanalized from the stapler occlusion with an average anastomosis exclusion time of 27.9 (14-70) days. The CDTI tube was removed on day 33 (20-75) and the subsequent stoma closure time was 12.3 (6-30) days.

CONCLUSION

The CDTI procedure is a safe and effective technique for defunctioning an elective low colorectal anastomosis and avoids a formal stoma.