Comparing the safety and efficacy of virtual ileostomy versus diverting ileostomy in patients undergoing total mesorectal excision for rectal cancer: a propensity-matched study.
Virtual ileostomy avoided a formal diverting stoma in most selected rectal cancer patients.
Comparing the safety and efficacy of virtual ileostomy versus diverting ileostomy in patients undergoing total mesorectal excision for rectal cancer: a propensity-matched study.
Diverting ileostomy (diverting ileostomy) reduces the clinical impact of anastomotic leakage but is associated with stoma-related complications, mandatory reversal, and substantial costs.
We aim to compare the clinical outcomes of virtual ileostomy (virtual ileostomy) and diverting ileostomy.
A single-center retrospective case-control propensity score-matched analysis was performed on patients who underwent laparoscopic or robot-assisted anterior resection for rectal cancer between September 2014 and January 2024.
a formal stoma was avoided in most patients selected for virtual ileostomy
We included 112 cases of virtual ileostomy and 500 cases of diverting ileostomy for propensity-matched analysis.
The incidence of anastomotic leakage (anastomotic leakage) was 15.3% (17/111) in the virtual ileostomy group and 9.9% (11/111) in the diverting ileostomy group, with no statistically significant difference observed (OR = 0.608, 95% CI [0.271, 1.366], P = 0.448).
0 [0, 22.6]; P = 0.087).
18.0 [14.0, 24.0]; P < 0.001).
In carefully selected patients, virtual ileostomy avoided the need for diverting ileostomy in 84.7% of patients who underwent laparoscopic or robot-assisted anterior resection.
Additionally, there was no significant difference in anastomotic leakage or 6-month complication burden.
Moreover, virtual ileostomy was associated with advantages in terms of lower costs, lower rate of scheduled secondary operations and shorter hospital stay.