Closure of loop ileostomy: potentially a daycase procedure?

Area of Science:

• Colorectal Surgery
• Surgical Outcomes Research
• Patient Discharge Protocols

Background:

• Ileostomy closures are common, incurring significant hospital bed days.
• Currently, no ileostomy closures are recorded as daycase procedures in the UK.
• The study aims to assess morbidity, mortality, and daycase feasibility for ileostomy reversal.

Purpose of the Study:

• Evaluate morbidity and mortality of ileostomy closure.
• Investigate the feasibility of performing ileostomy reversal as a daycase procedure.

Main Methods:

• Retrospective review of 138 patients undergoing loop ileostomy closure from May 2005 to July 2010.
• Data collected included primary surgery, closure method, length of stay, and complications (early/late).
• Analysis included assessing eligibility for a 23-hour discharge protocol.

Main Results:

• 80% of patients met criteria for a 23-hour stay, with no deaths in eligible patients.
• Early complications occurred in 30% of patients, but serious complications were only 5%.
• Median hospital stay was 4 days; 71% had no early complications.

Conclusions:

• Ileostomy reversal is a safe procedure with low serious morbidity.
• Performing ileostomy reversal as a daycase or 23-hour stay is feasible.
• A 23-hour stay protocol for ileostomy reversal is planned for implementation.