Diverting ileostomy in colorectal surgery: when is it necessary?

“The role of fecal diversion using a loop ileostomy in patients undergoing rectal resection and anastomosis is controversial. There has been conflicting evidence on the perceived benefit vs. the morbidity of a defunctioning stoma. This is a review of the relevant surgical literature evaluating the risks, benefits, and costs of constructing a diverting ileostomy in current colorectal surgical practice”

“Fecal diversion is recommended as a selective tool to protect or ameliorate an anastomotic leak after a colorectal anastomosis. It is most beneficial when used selectively in high-risk patients with low pelvic anastomoses that are at an increased risk for AL. New tools are needed to identify patients at high risk for anastomotic failure after anterior resection.”

Hanna MH, Diverting ileostomy in colorectal surgery: when is it necessary? Langenbecks Arch Surg. 2015 Feb;400(2):145-52. Full Text for Emory Users (Sign in to request via Interlibrary Loan)

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