Investigation of Mortality and Morbidity In Patients Associated With Low Anterior Resection and Ghost Ileostomy

Background: Ghost ileostomy is a new invented method that use in patients with low ant resection and colorectal anastomose. Ghost ileostomy can be used instead of converting stoma. CS (converting stoma) is critical after low rectal resection procedures due to its anastomosis leakage preventing role, especially in patients who are at higher risk but its complications are non-negligible. We approached a study of Ghost ileostomy to identify its probable post operation morbidity and mortality. The purpose of this study was to assess the prevalence of some Post operation morbidity such as anastomose bleeding or hematoma, prolong ileus, pulmonary emboly, intra abdominal abscess, wound site infection and other complications.
Methods: ۲۶ patients with low ant resection and colorectal anastomosis due to colon cancer without any risk factor between ۲۰۱۳ and ۲۰۱۴ were selected. Checking of anastomosis leakage after ۱۰-۱۴ days post operation was analyzed to assess the prevalence of anastomosis leakage and compare post operation morbidity and mortality.
Results: The mean age of cases was ۵۵ years (۴۰ to ۶۵). ۱۶ (۶۱.۵%) were male and ۱۰ (۳۸.۵%) female. average BMI is ۲۳.۷ and all of the patient are in the normal range. Our mortality rate was negative. ۲ patients (۰.۰۷۶%) suffered from prolong ileus and one patient (۰.۰۳۸%) had wound site infection. Other post operation morbidities such as anastomose bleeding or hematoma, pulmonary emboly, intra abdominal abscess were negative. We had no any stoma related morbidity and also no any anastomosis morbidity.
Conclusion: Anastomosis leakage is the most complication in colorectal surgeries. Diverting stoma can decrease complications of anastomosis leakage but there is no evidence of its preventing role. By using ghost ileostomy we can manage selective loop ileostomy and the complications will be reduced. The most reliable way for anastomosis leakage diagnosis is surgeon's suspicion. Converting stoma that use for preventing anastomosis leakage, has significant complications by its own. As the anastomosis leakage does not have a high prevalence we can use ghost ileostomy to reduce the complications and improving quality of life.