Diverting stomas: Comparing loop ileostomy with loop transverse colostomy

Introduction: Transverse loop colostomy is conventionally used to defunction the distal colon and rectum following certain surgical procedures. Loop ileostomy has recently become more widespread among colorectal surgeons. We compared these 2 procedures when used to defunction the distal colon and rectum. Methods: Subject were 43 patients undergoing closure of a diverting stoma between 1995 and 2000. They were divided into an ileostomy group (n=25; IS group) and a transverse colostomy group (n=18; CS group). Median follow-up was 41 months. Results: Age, gender and indication for surgery were similar in both groups. Between stoma construction and closure, no significant differences were observed except in the method of anastomosis. After stoma closure, significant differences were observed in the incidence of bowel obstruction (IS: 4.0%, CS: 33.3%; P=0.031) and length of postoperative hospital stay (IS: 7.6±2.5days, CS: 10.6±5.0 days; P=0.017). No difference was seen in other complications. Conclusion: These results indicate that the loop ileostomy may be the procedure of choice when a diverting stoma is needed to defunction the distal colon and rectum.