Study protocol evaluating the use of bowel stimulation before loop ileostomy closure to reduce postoperative ileus: a...

Area of Science:

• Gastroenterology
• Surgical Oncology
• Clinical Trials

Background:

• Postoperative ileus is a common complication following ileostomy closure.
• Defunctionalized bowel in loop ileostomies can undergo changes contributing to ileus.
• Previous single-center studies suggest preoperative bowel stimulation may be beneficial.

Purpose of the Study:

• To evaluate the effect of preoperative bowel stimulation on postoperative ileus after ileostomy closure.
• To assess secondary outcomes including length of stay and gastrointestinal function recovery.
• To conduct a cost analysis of the intervention.

Main Methods:

• Multicenter randomized controlled trial in Canadian institutions.
• Preoperative stimulation involves infusing the distal ileostomy limb with saline and a thickening agent.
• Intervention administered 10 times over 3 weeks prior to closure by trained nurses.

Main Results:

• Primary outcome: postoperative ileus, defined by intolerance to oral intake without obstruction.
• Secondary outcomes: length of stay, time to diet tolerance, flatus/stool passage, and overall morbidity.
• Blinded assessment of patient outcomes.

Conclusions:

• This protocol details the first multicenter study on preoperative bowel stimulation before ileostomy closure.
• Results could significantly impact postoperative care and patient recovery.
• The study aims to provide evidence for optimizing ileostomy closure outcomes.