Ghost ileostomy is a feasible alternative to protective ileostomy for rectal cancer patients post-surgery, aiming to reduce stoma-related burdens.

• In a trial of 80 patients, ghost ileostomy showed non-inferior rates of overall complications and readmissions compared to protective ileostomy.
• No significant differences in bowel obstruction or acute tubular necrosis were found between the two groups.

Ghost ileostomy could be safe for low-risk patients, but larger studies are needed to confirm these results and refine patient selection.