Endless Arguments Over Diversion Stomas

essary through further research whether PSS which is cosmetically superior but requires laborious dressing during the discharge of 2–3 weeks is worthwhile to replace the primary closure. Cheong et al. [5] mentioned that there were no differences between the fold-over technique and the resection anastomosis technique of ileostomy take down. The fold-over technique can be simpler and be more useful when the distal loop is short. However, it can increase the risk of contamination by bowel content, and the procedure may not be possible when the distal loop has been made narrow to prevent spill over. Many investigators have identified that a randomized, largescale study is needed in order to reach a firm conclusion, but each surgical procedure has advantages and disadvantages. And controlling all of the factors in a randomized study will not be easy. Therefore, a realistic alternative would be to choose an appropriate method depending on the situation by knowing the arguments and by understanding the advantages and the disadvantages of each procedure in creating and restoring diversion stoma.