Introduction/Background The aim of this study is to evaluate safety and efficacy performing a ghost ileostomy (GI) followed by an early postoperative endoscopy to dismiss anastomotic leek (AL) in patients undergoing colorectal resection secondary to deep endometriosis, in the interest of avoiding a loop ileostomy (LI).

Methodology This is a retrospective observational study conducted in a single center from January 2016 to February 2019, which included patients undergoing laparoscopic segmental rectal or rectosigmoid resection with end-to-end anastomosis. Statistical analysis was performed using the SPSS version 2.0 program.

Results Fourteen women with deep endometriosis involving the intestine underwent GI after laparoscopic rectal segmental or rectosigmoid resection. The mean distance of the anastomosis from the anal verge was 7.85 cm, and the mean surgical time was 332 minutes. An immediate postoperative anastomotic leak was observed in 7.1% of the patients, and in such cases the GI was converted to a real ileostomy without further complications. Thus, ileostomy was avoided in 92.8% of cases. The early postoperative endoscopy had a sensitivity and specificity of 100%. None of the patients required reoperation, and the mortality rate was 0%. To date, there have been no cases of disease recurrence. In all cases, symptoms related to endometriosis resolved. The most common short- to medium-term complication was the alteration of intestinal motility, but this condition persisted in only four women.

Conclusion The combination of GI with early postoperative endoscopy provides an advantage when performing colorectal and ileorectal anastomosis surgeries without other associated risk factors for AL, since it facilitates its detection and avoids complications secondary to protective ileostomies. This could be key for our endometriosis patients, who are typically young and without associated comorbidities.

Disclosures None.