A preliminary study of transcaecal ileostomy as an alternative to defunctioning ostomies.

Abstract

To evaluate the usefulness of a transcaecal ileostomy catheter for protecting distal lower rectal anastomosis as an alternative to conventional ileostomy. Patients with a rectal cancer located 3-10 cm from the anal verge were included in the study. In all cases, an open low or ultra-low anterior resection of the rectum was performed with total mesorectal excision. A balloon catheter was inserted through the caecum and ileocaecal valve, with the catheter's distal end placed in terminal ileum. A computed tomography (CT) scan was performed 7 days postoperatively to check the integrity of the anastomosis; the transcaecal catheter was withdrawn if no complications were detected. Eighteen patients were treated with a transcaecal catheter. Two patients developed cellulitis (11.1%) in the catheter exit wound. In both cases, successful healing was achieved within a month of surgery. One patient had anastomotic dehiscence (5.5%) after removal of the catheter following a normal CT examination. The median hospital stay was 10 days (range 8-13 days). A transcaecal ileostomy catheter to protect a distal rectal anastomosis is a potential alternative to loop ileostomy with potentially fewer complications and without need for a second procedure for closure.