Increased postoperative complications after protective ileostomy closure delay: An institutional study.
Ines Rubio-Perez1, Miguel Leon1, Daniel Pastor1
1Ines Rubio-Perez, Miguel Leon, Daniel Pastor, Joaquin Diaz Dominguez, Ramon Cantero, General and Digestive Surgery Department, La Paz University Hospital, 28046 Madrid, Spain.
World Journal of Gastrointestinal Surgery
|October 3, 2014
Summary
Ileostomy reversal in colorectal surgery patients has a high complication rate. Delayed closure increases risks, particularly wound infections and colitis, necessitating careful consideration of the procedure's timing.
Area of Science:
- Colorectal Surgery
- Surgical Morbidity
- Ostomy Management
Background:
- Ileostomy reversal is a common procedure following colorectal surgery.
- Understanding associated morbidity is crucial for patient care.
- The impact of closure timing on outcomes requires investigation.
Purpose of the Study:
- To investigate the morbidity and complications of ileostomy reversal.
- To determine if complication rates are linked to the time of stoma closure.
- To identify risk factors for adverse outcomes after ileostomy reversal.
Main Methods:
- Retrospective analysis of 93 patients undergoing elective ileostomy closure (2009-2013).
- Review of demographic, clinical, and surgical variables.
- Complications classified using the Clavien-Dindo Classification; statistical analysis performed.
Main Results:
- 40% of patients experienced postoperative complications, with 1% mortality.
- Ileus (13%) and wound infection (13%) were most frequent; pseudomembranous colitis occurred in 4%.
- Delayed ileostomy closure (average 10.3 months) was associated with increased overall complications, wound infections, and colitis.
Conclusions:
- Ileostomy reversal, despite being common, carries a significant complication rate.
- Delayed stoma closure is a modifiable risk factor for increased morbidity.
- Careful consideration of closure timing is essential to mitigate risks.
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