A sustaining rod increases necrosis of loop ileostomies: a randomized controlled trial

• Published in: International journal of colorectal disease 2017-06, Vol.32 (6), p.875-881
• Main Authors: Zindel, Joel, Gygax, Chantal, Studer, Peter, Kauper, Melanie, Candinas, Daniel, Banz, Vanessa, Brügger, Lukas E.
• Format: Article
• Language: English
• Subjects: Body mass; Body mass index; Clinical trials; Gangrene; Gastroenterology; Hepatology; Internal Medicine; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Morbidity; Necrosis; Original Article; Ostomy; Proctology; Risk factors; Surgery
• ISSN: 0179-1958; 1432-1262
• DOI: 10.1007/s00384-017-2813-9

Purpose Defunctioning loop ileostomies (LI) are commonly used in colorectal surgery to reduce the potentially detrimental consequences of anastomotic leakages. However, stoma-related morbidity is high with up to 75% of patients having local complications. The aim of this study was to investigate the effect of a sustaining rod on the local complication rate. Methods In this prospective, multi-center, randomized controlled trial, subjects were allocated to either a rod or a rod-less protocol (NCT00959738). The primary outcome was local morbidity as measured by a stoma specific morbidity score (SSMS) during the first 3 months postoperatively. Results Between August 2008 and July 2014, a total of 122 patients were enrolled in the study, of which 78 (63.8%) completed the study [44 (56.4%) rod, 34 (43.6%) rod-less]. There was no significant difference in the SSMS between the two groups. The incidence of necrosis or partial necrosis, however, was significantly increased in the rod group: 13 (29.5%) vs. 1 (2.9%) in the rod-less group ( p   26) was associated with an odds ratio of 5 ( p