End-loop Stoma versus the Traditional Two Separate Stomas after Intestinal Resection

Aim: To compare the technique of temporary partial intestinal anastomosis versus two separate stomas, following large bowel resection, in patients where the anastomosis is anticipated to have borderline margins with dubious viability. Patients and methods: Thirty patients underwent bowel resection, Group A (15 patients) had partially anastomosed end-loop stoma and Group B (15 patients had traditional two stomas technique. These operations were performed at the Ain Shams University Hospitals between November 2011 and October 2013. Patients with marked difference in the diameter between the cut ends of bowel loops after resection were added to the study. Bowel resection was performed because of conditions such as ischemic colitis, bowel mass and bowel injury. Results: Significant decrease in the intraoperative time was found where end loop stoma was constructed and also the operative time of stoma closure to regain bowel continuity in group A. As regard the complications, postoperatively, 1 of the patients of group A developed parastomal hernia and one patient of group B developed stoma necrosis which necessitated refashioning of the stoma. There were no major complications in group A. All patients were discharged between the 8th and 15th day after the procedure, and the stoma was closed 3 weeks to 12 weeks later. Conclusion: We believe that end-loop stoma is a simple, quick and safe technique with minimal stoma-related morbidity, and with simple and safe reversion. This technique can be considered as a useful option in the treatment of ischemic enteritis, and in the management of severe intestinal trauma.