Postoperative Ileus after Stimulation with Probiotics before Ileostomy Closure

Area of Science:

• Gastroenterology
• Surgical Oncology
• Clinical Research

Background:

• Postoperative ileus (POI) is a common complication following loop ileostomy closure after colorectal surgery, occurring in 13-20% of cases.
• Effective strategies to mitigate POI are crucial for improving patient recovery and reducing healthcare costs.

Purpose of the Study:

• To evaluate the efficacy and safety of preoperative stimulation of the efferent loop with probiotics before ileostomy closure in patients who underwent colorectal cancer surgery.
• To determine if probiotic stimulation impacts the incidence of POI and other recovery parameters.

Main Methods:

• A prospective, randomized, double-blind, controlled study was conducted.
• Patients undergoing colorectal cancer surgery with loop ileostomy were randomized into two groups: probiotic stimulation (cases, n=34) and control (n=35).
• Evaluated outcomes included POI incidence, nasogastric tube insertion, dietary tolerance, bowel function restoration, and hospital stay duration.

Main Results:

• The incidence of POI was similar between the probiotic group (9/34) and the control group (10/35), with a p-value of 0.192.
• Probiotic stimulation of the efferent loop did not significantly affect POI incidence after ileostomy closure.
• A correlation was observed between POI after oncological surgery and POI after reconstruction surgery, independent of probiotic stimulation.

Conclusions:

• Preoperative stimulation of the efferent loop with probiotics is not effective in preventing postoperative ileus after ileostomy closure.
• Postoperative ileus following ileostomy closure appears to be independent of this probiotic stimulation method.
• A potential relationship exists between postoperative ileus after reconstruction and prior ileus following colorectal cancer surgery.