After a ultra-low anterior resection with a coloanal anastomosis 3 cm from the anal verge, a temporary loop ileostomy is fashioned. What is the principal proven benefit of this stoma?
- A It reduces the clinical severity and need for emergency reintervention if a leak occurs ✓
- B It prevents formation of the anastomosis leak itself
- C It improves long-term survival from rectal cancer
- D It lowers the rate of local pelvic recurrence
Correct answer: A. It reduces the clinical severity and need for emergency reintervention if a leak occurs
Explanation
Randomised evidence shows that a defunctioning loop ileostomy does not reduce the overall rate of anastomotic leak, many leaks being radiological and asymptomatic. Its proven value lies in converting a clinically catastrophic leak into a minor event, reducing faecal peritonitis, emergency reoperation and mortality in low pelvic anastomoses. It confers no oncological benefit on survival or recurrence, which kills both outcome-related distractors.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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