Universität zu Köln

Hernandez, Alberto Vega, Otten, Jakob, Christ, Hildegard, Ulrici, Christoph, Piriyev, Elvin, Ludwig, Sebastian and Rudroff, Claudia (2022). Ghost Ileostomy: Safe and Cost-effective Alternative to Ileostomy After Rectal Resection for Deep Infiltrating Endometriosis. In Vivo, 36 (3). S. 1290 - 1297. ATHENS: INT INST ANTICANCER RESEARCH. ISSN 1791-7549

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Abstract

Background/Aim: Endometriosis infiltrating the rectum often requires resection with a protecting stoma. A ghost ileostomy (GI) is an alternative to prevent the psychological burden for the young women affected. The present study evaluated the safety and cost-effectiveness of the ghost ileostomy (GI) procedure in a group of patients after rectal resection for deep infiltrating endometriosis. Patients and Methods: The prospective controlled interventional trial was conducted in 54 consecutive patients with deep infiltrating endometriosis of the rectum. GI was considered after ultra-low resection with primary anastomosis, previous colorectal anastomosis, or pelvic redo surgery. Loop ileostomy (LI) was performed after simultaneous colpotomy with suture, only. Operating time, morbidity according to the Clavien-Dindo classification (CDC), duration of hospital stay, and patient satisfaction were obtained.Individual costs were estimated for the endometriosis procedure with or without a GI or LI, including stoma supply and closure expenses. Results: Of the 54 patients, 27 received GI (50%), whereas 4 underwent LI (7%). The remaining 23 patients received no outlet (NO). The complication rate did not differ among the GI, LI, and NO groups. Two cases were re-operated and required a diverting stoma, one in the GI and the NO group each. The additional healthcare expenses for each patient receiving a LI averaged 6,000 euro . The patients were very satisfied with the option of a GI. Conclusion: GI is a costeffective and safe alternative to LI after rectal resection for deep infiltrating endometriosis in cases where it is required. The individual costs per patient were reduced substantially, with a cumulative savings of 160,000 euro in healthcare expenditure. Additionally, the method clearly lowers the psychological burden on the young women concerned.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hernandez, Alberto Vega UNSPECIFIED UNSPECIFIED UNSPECIFIED Otten, Jakob UNSPECIFIED UNSPECIFIED UNSPECIFIED Christ, Hildegard UNSPECIFIED UNSPECIFIED UNSPECIFIED Ulrici, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Piriyev, Elvin UNSPECIFIED UNSPECIFIED UNSPECIFIED Ludwig, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Rudroff, Claudia UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-672097
DOI:	10.21873/invivo.12829
Journal or Publication Title:	In Vivo
Volume:	36
Number:	3
Page Range:	S. 1290 - 1297
Date:	2022
Publisher:	INT INST ANTICANCER RESEARCH
Place of Publication:	ATHENS
ISSN:	1791-7549
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DEFUNCTIONING STOMA; VIRTUAL ILEOSTOMY; SURGERY; COMPLICATIONS Multiple languages Medicine, Research & Experimental Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/67209