A 45-year-old man undergoes ultra-low anterior resection for a rectal cancer 4 cm from the anal verge. To protect the low pelvic anastomosis, what is the most appropriate method of proximal diversion?

• A Loop transverse colostomy
• B Tube cecostomy
• C End descending colostomy
• D Loop ileostomy ✓

Explanation

A loop ileostomy is the preferred method for defunctioning a low colorectal or coloanal anastomosis. It is technically easier to reverse than a colostomy, has lower output-related complications, and effectively diverts the fecal stream to reduce the morbidity of a potential anastomotic leak. Loop transverse colostomy is an alternative but is associated with higher complication rates and more difficult reversal.

Reference: Fischer's Mastery of Surgery, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.