Diverting Ileostomy and Transverse Colostomy Comparative Study
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Diverting ileostomy, Diverting Transverse Colostomy.
- Who it may be relevant to
- Registry conditions: Ileostomy, Colostomy, Colorectal Surgery. Basic parameters: 18 years — 80 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Center list to be confirmed — check the primary protocol.
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Unsure about the terms? Read our patient guide →
Official title
Diverting Ileostomy Verses Transverse Colostomy in Colorectal Surgery
Overview
Protective diverting stomas are frequently constructed after low anterior resection or colorectal anastomosis to mitigate the consequences of anastomotic leakage, one of the most feared complications in colorectal surgery. Both loop ileostomy (LI) and loop transverse colostomy (TC) are accepted methods of diversion. Randomized and observational studies have shown that faecal diversion significantly reduces the clinical severity of leaks and the need for reoperation compared with no diversion. The choice between LI and TC remains controversial. Loop ileostomy is technically straightforward and associated with shorter operative time and fewer septic complications at closure. However, it carries specific risks, including high-output stoma, dehydration, electrolyte imbalance, and renal impairment, which may lead to hospital readmissions. Conversely, loop transverse colostomy is associated with fewer fluid and electrolyte issues, but has higher rates of prolapse, skin irritation, and wound complications at closure. Meta-analyses comparing LI and TC indicate no clear superiority, with each approach demonstrating distinct patterns of morbidity. Some randomized trials have suggested lower major morbidity with LI, while others found no significant difference. Given the heterogeneity of outcomes and limited high-quality, adequately powered trials, further randomized evidence is needed to guide optimal stoma selection in colorectal surgery.
Interventions
- Procedure Diverting ileostomy
a surgical procedure in which the a segment of the ileum is mobilized and placed as a stoma diverting technique to protect any distal anastomosis - Procedure Diverting Transverse Colostomy
a surgical procedure in which the a segment of the transverse colon is mobilized and placed as a stoma diverting technique to protect any distal anastomosis.
Primary outcome measures
- Number of Participants With Clinically or Radiologically Confirmed Anastomotic Leak [Time frame: From index colorectal surgery to 30 days after surgery]
- Severity of Anastomotic Leak Assessed by Clavien-Dindo Classification [Time frame: From index colorectal surgery to 30 days after surgery]
- Number of Participants With Anastomotic Leak Requiring Surgical Management [Time frame: From index colorectal surgery to 30 days after surgery]
Secondary outcome measures (4)
- Intraoperative Blood Loss During Index Surgery [Time frame: Intraoperative period of index surgery]
- Number of Participants With Postoperative Bleeding Requiring Transfusion or Intervention [Time frame: From index colorectal surgery to 30 days after surgery]
- Operative Time for Index Surgery [Time frame: Intraoperative period of index surgery]
- Length of Hospital Stay After Index Surgery [Time frame: Baseline]
Eligibility criteria
Inclusion criteria
- • Adults ≥18 years undergoing elective low anterior resection or coloanal anastomosis for benign or malignant colorectal disease.
- Patients for whom the surgeon has decided that a diverting stoma is required such as emergency resection and anastomosis cases where a covering stoma is indicated.
- Ability to provide informed consent.
Exclusion criteria
- • Patients with pre-existing stoma.
- Severe comorbidities precluding stoma creation (e.g., advanced renal failure, uncontrolled cardiac disease).
- Patients with extensive peritoneal carcinomatosis or unresectable disease.
- Pregnant or lactating women.
- Inability to comply with follow-up or provide informed consent.
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Open label
- Primary purpose
- Treatment
Study locations
Center list to be confirmed — check the primary protocol.
Identifiers
NCT: NCT07283952 · Stoma Type Comparison