Complications and Readmissions in Diverting Loop Ileostomies and Loop Colostomies

Area of Science:

• Gastroenterology
• Surgical Oncology
• Colorectal Surgery

Background:

• Fecal diversion is a common surgical procedure with debated optimal choices between loop ileostomies and loop colostomies.
• Morbidity can differ significantly between these diversion types.

Purpose of the Study:

• To compare readmissions and stoma-related complications between patients with diverting loop ileostomy and loop colostomy.

Main Methods:

• Retrospective cohort study at a single academic tertiary medical center.
• Included adults (≥18 years) who underwent temporary diverting loop ileostomy or colostomy between 2015 and 2025.
• Analyzed readmissions, stoma complications, revision rates, and pouching issues.

Main Results:

• Ileostomies had higher readmission rates (23% vs 13%) and dehydration-related readmissions (60% vs 11%).
• Ileostomy patients reported more pouching issues (68% vs 43%), while colostomy patients had higher prolapse (16% vs 4%) and revision rates (12% vs 4%).
• Ileostomy independently associated with higher odds of readmission (OR: 3.15).

Conclusions:

• Diverting ileostomies are associated with more frequent readmissions and dehydration compared to colostomies.
• Colostomies present higher prolapse rates, but not necessarily higher revision rates.
• Surgeons should discuss these differential outcomes with patients when considering diversion options.