Protective ileostomy: complications and mortality associated with its closure

Area of Science:

• Colorectal Surgery
• Surgical Complications
• Gastrointestinal Procedures

Background:

• Loop ileostomies are frequently employed in colorectal surgery to safeguard low rectal anastomoses.
• Complications can arise during or after the stoma closure procedure.
• This study evaluates the outcomes of loop ileostomy closures at a single institution.

Purpose of the Study:

• To analyze the complications associated with loop ileostomy closure.
• To assess the morbidity and mortality rates following stoma reversal.
• To provide insights into the management of patients undergoing ileostomy closure.

Main Methods:

• A retrospective analysis of patients who underwent loop ileostomy closure between 2006 and 2010.
• Data collected included patient demographics, indication for ileostomy, waiting time for closure, complication types and frequency, hospital stay, and mortality.
• Eighty-nine patients were included in the study.

Main Results:

• The mean waiting time for stoma closure was 8 months.
• A significant complication rate of 45.9% was observed.
• Common complications included intestinal obstruction (32.6%), surgical wound infection (6%), and enterocutaneous fistula (4.5%). One patient (1.12%) died post-operatively.

Conclusions:

• Loop ileostomies are crucial for preventing anastomotic leakage in low rectal reconstructions.
• Stoma closure, though often considered routine, is a major procedure with potential for serious complications, including mortality.
• Careful consideration and management are required for ileostomy closure to mitigate risks.