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Loop ileostomy for temporary fecal diversion
R E Khoo1, M M Cohen, G M Chapman
1Department of Surgery, Rose Medical Center, Denver, Colorado.
American Journal of Surgery
|May 1, 1994
Summary
Loop ileostomies are safe and effective for temporary fecal diversion in ileoanal pouch procedures. Creating and closing these ileostomies results in low morbidity and few complications.
Area of Science:
- Gastroenterology and Surgery
- Surgical Outcomes
- Stoma Care
Background:
- Ileostomies are frequently used for temporary fecal diversion after ileoanal pouch procedures.
- Assessing the morbidity associated with loop ileostomy creation and closure is crucial for patient management.
Purpose of the Study:
- To prospectively evaluate the morbidity associated with creating and closing loop ileostomies in patients undergoing ileoanal pouch procedures.
- To determine the safety and efficacy of loop ileostomies as a temporary diversion method.
Main Methods:
- Prospective study of 203 consecutive patients undergoing ileoanal pouch procedures with loop ileostomy creation between 1983 and 1991.
- Analysis of complications related to ileostomy creation, diversion, and closure.
Main Results:
- Low overall morbidity: 1 death (liver failure), 1 pouch-vaginal fistula requiring pouch excision.
- Of 201 patients with ileostomy closure, only 7% required surgery for ileostomy-related issues.
- Post-closure complications occurred in only 2% of patients.
Conclusions:
- Loop ileostomy creation and closure are associated with low morbidity and few complications.
- Loop ileostomy is an effective and safe method for temporary fecal diversion, potentially reducing pouch sepsis.
- Loop ileostomy is recommended as the stoma of choice for temporary fecal diversion in various clinical scenarios.