Risk factors for postoperative ileus following loop ileostomy closure

Area of Science:

• Gastroenterology
• Surgical Oncology
• Colorectal Surgery

Background:

• Postoperative ileus (POI) is a frequent complication after loop ileostomy closure (LIC).
• Identifying risk factors for POI is crucial for improving patient outcomes and developing preventive strategies.

Purpose of the Study:

• To investigate the risk factors associated with the development of POI following loop ileostomy closure.
• To provide recommendations for the prevention of POI after LIC.

Main Methods:

• Retrospective analysis of patients undergoing LIC with peristomal incision after distal colorectal surgery.
• Evaluation of complications including POI, surgical site infection (SSI), bleeding, and anastomosis leakage using standardized criteria.
• Univariate and independent variable analysis to identify significant risk factors for POI.

Main Results:

• POI developed in 9 out of 79 patients.
• Univariate analysis identified age <60, comorbidities, open technique in primary surgery, total colectomy, hand-sewn anastomosis in LIC, and blood transfusion as risk factors for POI.
• Independent risk factors for POI were hand-sewn anastomosis during LIC and open technique in the initial surgery.

Conclusions:

• The use of an open technique during the initial surgery and a hand-sewn anastomosis during loop ileostomy closure are associated with an increased risk of postoperative ileus.
• These findings suggest modifications in surgical approach may help reduce POI incidence.