A review of diversionary procedures for distal colorectal anastomosis

Abstract

The morbidity associated with a low colorectal or coloanal anastomotic leak, which can rarely be fatal, is reduced by the use of a defunctioning stoma to divert the proximal faecal stream. Up to the present moment, there has been continuing controversy regarding the optimal method of defunctioning a distal anastomosis, the choice resting between either a loop ileostomy (LI) or loop transverse colostomy (LTC). This review discusses both the above diversionary methods in detail and the resulting outcome following surgery. The collective results from this review indicate an advantage of loop ileostomy over transverse loop colostomy as the preferred method of temporary faecal diversion in low colorectal and coloanal anastomoses.