Comparison of complication rates after early and late closure of loop ileostomies: A retrospective cohort study

In the treatment of rectal cancer, a temporary loop ileostomy (TLI) is created after low anterior resection to protect bowel function in the postoperative period. Dehydration and kidney failure are significant potential complications in loop ileostomies. Compared to late closure (3-6 months), early closure (10-14 days) of the TLI may facilitate faster patient recovery and shorter hospital stays.

To compare early and late closure of TLIs and demonstrate that early stoma closure can be performed without increasing morbidity.

This study included patients who underwent TLI for rectal cancer, with data collected prospectively between June 2016 and October 2024 and analyzed retrospectively. Patients whose stomas were closed in the late period (3-6 months) between June 2016 and October 2022 (group A) were compared with those who underwent early closure (10-14 days) between October 2022 and 2024 (group B), with the primary outcome being complication rate and the secondary outcome being quality of life.

A total of 270 TLIs were created (70.9%). Of these, 120 (44.4%) were closed in the late period (group A), and 150 (55.6%) were closed in the early period (group B). There was no statistically significant difference between group A and group B in terms of demographic and clinicopathological characteristics (P > 0.05). Perioperative (anesthesia management, operative time, blood loss, surgical technique) and postoperative findings (anastomotic leak, infection) were similar between the two groups and were not statistically significant (P > 0.05). There were no statistically significant differences in complication rates as the primary outcome between the two groups. Quality of life as a secondary outcome was significantly higher in the early closure group (P < 0.05).

No statistically significant difference was found between early and late loop ileostomy closure in terms of perioperative and postoperative morbidity. Early closure accelerated patients' psychological and social recovery.