Multivariate analysis of risk factors for complications after loop ileostomy closure

Despite the advantages of diverting loop ileostomy construction, it is related to complications.

The aim of the study was to determine the risk factors for complications after loop ileostomy closure.

Patients who underwent loop ileostomy closure from January 2010 to March 2018 were retrospectively analyzed. Multivariate logistic regression was used to determine the effect of the potential risk factors on the rate of each complication.

A total of 136 patients underwent reversal. Indications for the initial operation were colorectal cancer (39.7%), diverticulitis (25.7%), idiopathic chronic ulcerative colitis (ICUC) (8.1%), familial adenomatous polyposis (FAP) (7.4%), and others (19.1%). Multivariate analysis identified the following risk factors: type of incision (midline laparotomy) (odds ratio [OR] = 6.5) for wound infection; treatment with immunomodulator (OR = 12.5) for anastomotic leak; history of FAP (OR = 9.8) for intestinal obstruction; previous use of immunomodulator (OR = 10.0) and performing reversal through midline incision (OR = 18.9) for reoperation; and ≥ 65 years old (OR = 3.5) for medical complications. The rate of incisional hernia was 11%, and the risk factors were time to closure < 3 months (OR = 6.4) and parastomal hernia (OR = 13.2).

Several patient-related and surgical technique factors should be considered at the time of loop ileostomy closure to reduce post-operative morbidity.