[Ileostomy closure after necrotizing enterocolitis. When is the best moment?]

In more than 50% of the necrotizing enterocolitis that underwent surgery will require an ileostomy. The optimal time to reestablish intestinal transit still is a controversial subject. Many times ileostomies cause medical issues that require early intestinal reconstruction. Our objective is to compare the early closure against late close, being the shift point 35 days according to other published research.

Retrospective study off all patients that in the last 10 years have had an episode of necrotizing enterocolitis which required an intestinal derivation like ileostomy.

We studied 39 patients, 22 had an early closure (EC) and 17 in had a late closure (LC). There were statistically significant differences in age and weight between both groups, being younger in the EC group (p<0,05). All the morbidity factors were greater in the EC group (days of parenteral nutrition, days of central venous catheter, inotropic use, surgical wound infection and intestinal occlusions). The days of mechanical ventilation were greater in the EC group (2,33 vs p=0,017). The rate of reoperation was higher in the EC group (31%) against the LE group (17%).

It is necessary to perform prospective studies with larger number of patients to be able to recommend a late closure ileostomy. In our experience the early closure has more morbidity and a higher rate of surgical reoperations.