Comparison of completely diverted tube ileostomy and conventional loop ileostomy

Objective and background: Defunctioning diverting ileostomies are commonly performed to prevent severe morbidity and mortality caused by colorectal anastomotic leakage. However, severe complications may develop due to loop ileostomy itself and its reversal. In this study, it was aimed to compare the results of completely diverted tube ileostomy with rubber strip and conventional loop ileostomy. Materials and Methods: Completely diverted tube ileostomy with rubber strip was performed in the 20 consecutive patients for fecal diversion between July 2018 and July 2020. Loop ileostomy was performed in the next 20 consecutive patients. The study was designed retrospectively while data was collected prospectively. The primary outcome of the study is to compare both methods in terms of complications. Length of hospital stay, stoma-free survival rate, cost-effectiveness and achieving complete diversion were evaluated as secondary outcomes. Results: There was no statistically significant differences in age, sex and BMI between the two groups. The number of patients who developed any kind of complications during the observation period was significantly higher in the loop ileostomy group in comparison with tube ileostomy group [13 (65%) vs 3 (15%) respectively, p=0.002]. Median time experienced with stoma was statistically higher in loop ileostomy group in comparison with tube ileostomy group [270 days (56-443) vs 21 days (14-28) respectively, p<0.001]. Conclusion: Completely diverted tube ileostomy is superior to the loop ileostomy for the reasons such as; the lack of need for ileostomy reversal surgery, the fact that it causes fewer complications compared to loop ileostomy and is more cost-effective. Completely diverted tube ileostomy can be preferred easily to achieve fecal diversion instead of loop ileostomy. Keywords: Tube ileostomy, loop ileostomy, fecal diversion, anastomotic leakage, rectal cancer