January 2016 Vol. 4 No.1

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Original Research Article

Evaluation of Protective Stoma in Rectal Cancer Surgery

Devid Belalla^*, Nikollaq Kacani and Arben Gjata

Clinic of visceral surgery “Mother Theresa Hospital”,Tirana, Albania

*Corresponding Author’s E-mail: drbelalla@gmail.com

Accepted January 02, 2016

Abstract

Protective ileostomy is used to prevent anastomose leaking in low anterior resection, but its value is still controversial. This study aims to evaluate the role of protective ileostomy in preventing anastomose leaking and the need of reoperation. This is a retrospective study of 217 cases anterior resection of middle and lower rectum. All the data was collected in the IIId Clinic of Surgery at Mother Theresa Hospital, from January 2005 to October 2015. Clinical decision, for the need of protective jejunostomy, included: tumor localization, operatory hemorrhage, lymph node removement, simultaneous resection of other organs and the level of anastomose, previous chemo-radiotherapy, etc. Anastomotic leaks were found in 21 patients, or 9.7%. It was found a mortality rate of about 1.8% or 4 patients. Protective ileostomy was realized in 76 patients, of whom 9 had anastomose leak. The other 12 cases of anastomose leak were observed in patients who had not a protective ileostomy. Reoperation for fistula was performed in 10 cases, 8 of them did not had a protective stoma. Anterior resection, as the preferred treatment of low rectum cancer, has a low mortality and acceptable morbidity. As regards the value ileostomy in preventing anastomose leakage, there was no statistically difference between the two groups, but it might minimize the consequences and reduces the need for urgent reoperation.

Key words: Anastomotic leakage, Low anterior resection, Protective stoma, Rectal cancer, Total mesorectal excision.