Quality of life following ileostomy takedown: single-centre, retrospective clinical trial-does closure time matter?

This study aimed to assess whether early closure of loop ileostomy reduces the rate of postoperative complications related to ileostomy closure and improves patients' quality of life, as measured by the Low Anterior Resection Syndrome (LARS) and Wexner questionnaires.

All patients who underwent low anterior resection + ileostomy with subsequent reversal between January 2019 and May 2023 were included in the study. Patients were divided into two groups: early (< 3 months) and late closure (> 3 months). There were 46 (43%) patients in the early closure group and 61 (57%) in late closure. In this study, patients' demographics and complication rate (categorised by severity using the Clavien-Dindo scale) were assessed.

We assessed and contacted 180 patients. Of these, 107 (59%) completed the LARS and Wexner questionnaires. Of the 107 patients, 51 were male (47.7%) and 56 female (52.3%). The time to ileostomy closure ranged between 0.5 and 28 months, with a median of 5. In the early and late closure groups, postoperative complications were observed in 4.3% vs. 14.8% (p = 0.08) of patients and postoperative ileus occurred in 6.5% vs. 4.9% (p = 0.72) of patients respectively. Median LARS score was 25 vs. 20 (p = 0.99) and Wexner's 2.5 vs. 2 (p = 0.82), respectively. The previously discussed indicators (postoperative ileostomy complications, postoperative ileus rate, LARS and Wexner scores) were not statistically significantly different.

In our small retrospective study, early ileostomy closure did not affect postoperative complications related to ileostomy closure and bowel dysfunction rates compared to late closure.

This study was a secondary analysis of the prospective trial registered at ClinicalTrials.gov no. NCT03607370, 01.07.2017.