Ileostomy or colostomy for temporary decompression of colorectal anastomosis. Systematic review and meta-analysis.

Autor:	Güenaga KF; Division of Gastroenterology, Metropolitana University, Santos, SP, Brazil. kfg012@terra.com.br, Lustosa SA, Saad SS, Saconato H, Matos D
Jazyk:	angličtina
Zdroj:	Acta cirurgica brasileira [Acta Cir Bras] 2008 May-Jun; Vol. 23 (3), pp. 294-303.
DOI:	10.1590/s0102-86502008000300014
Abstrakt:	Purpose: The controversy regarding whether loop ileostomy or loop transverse colostomy is a better method for temporary decompression of colorectal anastomosis motivated this review. Methods: Five randomized trials were included, with 334 patients: 168 in the loop ileostomy group and 166 in the loop transverse colostomy group. The outcomes analyzed were: 1. Mortality; 2. Wound infection; 3. Time of stoma formation; 4. Time of stoma closure; 5. Time interval between stoma formation and closure; 6. Stoma prolapse; 7. Stoma retraction; 8. Parastomal hernia; 9. Parastomal fistula; 10. Stenosis; 11. Necrosis; 12. Skin irritation; 13. Ileus; 14. Bowel leakage; 15. Reoperation; 16. Patient adaptation; 17. Length of hospital stay; 18. Colorectal anastomotic dehiscence; 19. Incisional hernia; 20. Postoperative bowel obstruction. Results: Stoma prolapse was statistically significant (p = 0.00001), but with statistical heterogeneity; the sensitive analysis was applied, excluding the trials that included emergency surgery, and this showed: p = 0.02, with I2 = 0% for the heterogeneity test. Conclusions: The outcomes reported were not statistically or clinically significant except for stoma prolapse. Better evidence for making the choice between loop ileostomy or loop colostomy requires large-scale randomized controlled trials.
Databáze:	MEDLINE
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