The outcome of loop ileostomy closure: a prospective study.

BACKGROUND

The use of a loop ileostomy is an effective method to protect pelvic anastomoses, although there is some debate as to the routine use of a stoma. A second operation is required to close the stoma, with potential complications.

OBJECTIVE

The aim of this study was to assess prospectively the morbidity of closure of loop ileostomy.

METHOD

All patients scheduled for loop ileostomy closure over a 12-month period were included. The patient demographics, operative technique, complications and length of stay were recorded prospectively.

RESULTS

Fifty consecutive patients (28 males and 22 females) with a median age (interquartile range, IQR) of 56 (42-73) years underwent closure of loop ileostomy, at a median time (IQR) of 29 (18-48) weeks after formation. Twelve patients (24%) developed complications: six (12%) had intestinal obstruction of which one required a laparotomy, four (8%) had wound infections of which one required re-operation, one (2%) had an ileal anastomotic leak and subsequently died and one (2%) died from a myocardial infarction. The median length (IQR) of hospital stay was 8 (7-10) days.

CONCLUSION

We have demonstrated that a quarter of patients develop complications after loop ileostomy closure. The majority of these are minor. Methods to reduce the number of complications, such as optimum time for closure and distal limb irrigation techniques, need to be studied.