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Loop ileostomy closure after restorative proctocolectomy: outcome in 1,504 patients
Kutt-Sing Wong1, Feza H Remzi, Emre Gorgun
1Department of Colorectal Surgery, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
Diseases of the Colon and Rectum
|February 17, 2005
Summary
Ileostomy closure after restorative proctocolectomy has low complication rates and short hospital stays. Both handsewn and stapled closure techniques showed similar outcomes, supporting their routine use in patients undergoing restorative proctocolectomy.
Area of Science:
- Gastroenterology and Surgical Innovation
- Colorectal Surgery Outcomes
Background:
- Temporary loop ileostomy is often used for diversion after restorative proctocolectomy.
- The morbidity associated with ileostomy creation and closure remains a point of clinical debate.
Purpose of the Study:
- To evaluate the complication rates associated with loop ileostomy closure.
- To compare complication rates between handsewn and stapled closure methods following restorative proctocolectomy.
Main Methods:
- A retrospective review of the Pelvic Pouch Database was conducted.
- Data from 1,504 patients who underwent ileostomy closure between 1983 and 2002 were analyzed.
Main Results:
- The overall complication rate for ileostomy closure was 11.4%, with common issues including small-bowel obstruction (6.4%) and wound infection (1.5%).
- Hospitalization averaged three days, with no significant difference in complication rates or length of stay between handsewn (85%) and stapled (15%) closure techniques.
Conclusions:
- Ileostomy closure after restorative proctocolectomy is a safe procedure with low morbidity and brief hospitalizations.
- Both handsewn and stapled closure methods demonstrate comparable safety and efficacy.