Risk Factors for Postoperative Complications of Ileostomy Reversal

Purpose: The aim of this study was to investigate the risk factors for postoperative complications following ileostomy reversal. Materials and methods: The databases PubMed, Embase, and Cochrane Library were independently searched by the two authors from inception to December 30, 2024. Odds ratios (ORs) and 95% confidence intervals (CIs) were pooled up for describing dichotomous variables. Stata 16 was performed for data. Results: After pooling up the data, a total of 19 studies involving 11108 patients were included in this study. The outcomes showed that any complication after primary procedure (OR = 2.51, 95% CI = 1.66 to 3.79, I² = 1.97%, P < .01) were associated with ileostomy reversal complications. In addition, obesity (OR = 1.45, 95% CI = 1.17 to 1.79, I² = 0.00%, P < .01), linear wound closure (OR = 6.63, 95% CI = 1.59 to 27.76, I² = 0.00%, P < .01), higher American Society of Anesthesiologists (ASA) scores (OR = 1.70, 95% CI = 1.33 to 2.18, I² = 3.33%, P < .01), and longer operative time (OR = 1.30, 95% CI = 1.11 to 1.53, I² = 97.32%, P < .01) were associated with wound infection. Conclusion: For patients with complications after the initial surgery, surgeons should be aware of the risks of complications following ostomy reversal. Obesity, longer operative time, and higher ASA scores were risk factors for wound infections. Purse-string skin closure had certain advantages over linear skin closure in reducing incision infections.