Evidence map›Paper›PMID 39520543›Full record

Trial reportLangenbeck's archives of surgery2024

Ghost-ileostomy versus conventional loop ileostomy in patients undergoing low anterior resection for rectal cancer: results of a randomised controlled multicentre pilot trial (DRKS00013997).

Felix J Hüttner, Pascal Probst, André L Mihaljevic, Lukas D Sauer, Colette Doerr-Harim, Alexis Ulrich, Samira Stratmeyer, Rosa Klotz, Markus K Diener, Phillip Knebel

Abstract readRandomized Controlled TrialMulticenter StudyComparative Study
PubMed Publisher
In one paragraph

Trial report in Langenbeck's archives of surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Felix J HüttnerDepartment of General and Visceral Surgery, Ulm University Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany. felix.huettner@uni-ulm.de.
Pascal ProbstDepartment of Surgery, Cantonal Hospital Thurgau, 8501, Frauenfeld, Switzerland.
André L MihaljevicDepartment of General and Visceral Surgery, Ulm University Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
Lukas D SauerInstitute of Medical Biometry (IMBI), Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.
Colette Doerr-HarimDepartment of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany.
Alexis UlrichSurgical Department I, Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany.
Samira StratmeyerSurgical Department I, Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany.
Rosa KlotzDepartment of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany.
Markus K DienerDepartment of General, Visceral and Thoracic Surgery, Klinikum Nürnberg, Prof.-Ernst-Nathan-Str. 1, 90419, Nuremberg, Germany.
Phillip KnebelDepartment of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe objective of the current pilot trial was to evaluate whether ghost ileostomy is a safe alternative to the current standard of care in terms of a conventional loop ileostomy in patients undergoing low anterior resection with total mesorectal excision (LAR/TME) for rectal cancer.

methodsThis randomized controlled pilot trial included patients undergoing LAR/TME, randomly assigning them to ghost ileostomy or conventional loop ileostomy intraoperatively. Follow-up spanned 6 months, evaluating the following endpoints: comprehensive complication index (CCI), postoperative morbidity, transformation of ghost ileostomy, presence of ostomy at 6 months, Wexner score, and quality of life (EORTC QLQ-C30 & CR29). Exploratory statistical analysis based on the intention-to-treat principle was conducted.

resultsRecruiting 30 patients from May 2018 to September 2022, the trial was prematurely stopped due to slow recruitment. The mean CCI was comparable between groups at any point of time (at 6 months: 30.7 vs. 29.7, p = 0.889). There was no mortality and no need for creation of a terminal ostomy. Anastomotic leakage rates were similar in ghost ileostomy and loop ileostomy groups (p > 0.99). The ghost ileostomy was converted into a conventional loop ileostomy in 6 of 15 (40.0%) patients. Neither postoperative function, nor the overall quality of life showed significant differences.

conclusionGhost ileostomy appears as a viable and safe option for selectively deciding ileostomy creation in LAR/TME for rectal cancer. However, challenges in patient selection, excluding those at high risk for anastomotic leakage, limit widespread application and call for optimization in future research. TRIAL-REGISTRATION: German Clinical Trials Register ( https://drks.de/ ): DRKS00013997; date of registration: April 9th 2018.

Indexed as

IleostomyQuality of LifeRectal NeoplasmsAdultAgedFemaleHumansMaleMiddle AgedPilot ProjectsPostoperative ComplicationsProctectomyTreatment OutcomeIleostomyLow anterior resectionTotal mesorectal excisionRectal cancer

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.