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Loop ileostomy: technical aspects and complications.

E Carlsen1, A B Bergan

  • 1Surgical Department B, National Hospital, Oslo, Norway.

The European Journal of Surgery = Acta Chirurgica
|April 7, 1999
PubMed
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This study on loop ileostomies found complications occurred during both construction and closure, with small intestinal obstruction being most common. Despite these issues, fecal diversion remains valuable in complex pelvic surgery.

Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Colorectal Surgery

Background:

  • Loop ileostomies are frequently employed for fecal diversion in complex pelvic surgeries.
  • Assessing complication rates associated with loop ileostomy construction and closure is crucial for patient outcomes.

Purpose of the Study:

  • To investigate the incidence of complications related to the construction and subsequent closure of loop ileostomies.
  • To evaluate the overall patient outcomes following loop ileostomy procedures.

Main Methods:

  • A retrospective study was conducted at a university hospital in Norway.
  • Data from 100 patients involving 103 loop ileostomies, operated between 1980 and 1990, were analyzed.
  • Complication rates following both ileostomy construction and closure were the primary outcome measures.

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Main Results:

  • Re-operation was required in 7 cases after construction and 11 after closure, predominantly due to small intestinal obstruction.
  • Stomal necrosis occurred in 2 patients. Post-closure leaks from the ileal anastomosis necessitated further surgery in 6 patients.
  • Secondary loop ileostomies were maintained significantly longer than primary ones (43 vs. 21 weeks).

Conclusions:

  • Loop ileostomy construction and closure present a notable rate of complications, including obstruction and anastomotic leaks.
  • Despite complications, fecal diversion via loop ileostomy is considered justified in complex pelvic surgery.
  • Further efforts are needed to minimize complication rates associated with these procedures.