Complications and Management of Umbilical Diverting Loop-Ileostomy in the Treatment of Rectal Cancer

Tanaka Sumie, Takemasa Ichiro, Miyo Masaaki, Uemura Mamoru, Nishimura Junichi, Hata Taishi, Mizushima Tsunekazu, Yamamoto Hirofumi, Doki Yuichiro, Mori Masaki

doi:10.3862/jcoloproctology.68.287

Diverting ileostomy is created usually in the right lower quadrant of the abdomen to reduce the anastomotic leakage rate in rectal surgery. The transumbilical approach used in single-incision laparoscopic surgery will improve cosmesis remarkably. Accordingly, creating a diverting ileostomy in the umbilicus may provide a better cosmetic outcome, although it may make stoma management more difficult than the usual procedure. To address this problem, the complications and management of 16 patients with rectal cancer who underwent low anterior resection with umbilical diverting loop-ileostomy were evaluated. The ostomy appliances could be mounted to the skin without difficulties or problems in all patients. There was no ileostomy-related complication such as parastomal hernia, retraction or prolapse. The level of peristomal dermopathy was evaluated with DET score and ABCD-stoma. A decrease of the score from the time of starting self-management to the time of stoma closure indicated that umbilical ileostomy does not prevent self-management. In conclusion, our study revealed that umbilical diverting loop-ileostomy in rectal cancer treatment may be feasible and promising for good cosmesis.

Complications and Management of Umbilical Diverting Loop-Ileostomy in the Treatment of Rectal Cancer

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