Double-tube End Ileostomy: A Viable Alternative in Rectal Cancer Surgery

Overview

This retrospective study compared double-tube end ileostomy with traditional end ileostomy in 65 patients undergoing laparoscopic low anterior resection for rectal cancer. The double-tube ileostomy group demonstrated shorter stoma creation times, reduced hospital stays, lower costs, fewer complications, and better psychological outcomes.

Background

Defunctioning ileostomy is commonly used to protect anastomoses after low anterior resection for rectal cancer, aiming to reduce the risk and severity of anastomotic leakage. Traditional end ileostomy, however, can be associated with longer operative times, higher complication rates, and significant physiological and psychological burdens. The double-tube end ileostomy technique has been proposed as an alternative to improve clinical outcomes and reduce patient morbidity.

Data Highlights

Key Findings

• No significant differences in intraoperative blood loss, postoperative bowel recovery, or overall complication rates between groups.
• Double-tube ileostomy associated with significantly shorter stoma creation time and postoperative hospital stay.
• Lower total hospitalization costs observed in the double-tube ileostomy group.
• Fewer anastomotic leakages and no long-term complications after tube removal in the double-tube group.
• Higher successful stoma closure rate in double-tube ileostomy patients compared to traditional ileostomy.
• Patients with double-tube ileostomy reported better psychological outcomes, including less somatization and fewer sleep and eating problems.

Clinical Implications

Double-tube end ileostomy represents a safe and effective alternative to traditional ileostomy in rectal cancer surgery, offering benefits such as reduced operative time, shorter hospitalization, and decreased healthcare costs. Additionally, it may reduce the incidence of long-term complications and improve patients' psychological well-being, potentially enhancing overall recovery and quality of life.

Conclusion

The double-tube end ileostomy technique provides a viable and advantageous option for defunctioning stomas in rectal surgical procedures, combining safety with improved clinical and psychosocial outcomes compared to traditional methods.

References

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2. Kapiteijn E et al. 2001 -- Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer
3. Chiarello MM et al. 2022 -- Anastomotic leakage in colorectal cancer surgery
4. Hrebinko K et al. 2024 -- Prophylactic defunctioning stomas improve clinical outcomes of anastomotic leak following rectal cancer resections
5. Albulescu EL et al. 2023 -- The role of ileostomy in the prevention and treatment of anastomotic leakage after elective rectal cancer surgery