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Temporary loop ileostomy for restorative proctocolectomy

A Senapati1, R J Nicholls, J K Ritchie

  • 1Department of Surgery, St Mark's Hospital, London, UK.

The British Journal of Surgery
|May 1, 1993
PubMed
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Temporary ileostomies after restorative proctocolectomy are associated with complications, primarily obstruction. While generally less frequent than reported elsewhere, these complications require careful management and monitoring post-surgery.

Area of Science:

  • Gastroenterology and Surgical Oncology

Background:

  • Defunctioning ileostomies are employed after restorative proctocolectomy to prevent pelvic sepsis.
  • However, ileostomies themselves can lead to complications.

Purpose of the Study:

  • To evaluate the incidence and types of complications associated with temporary defunctioning ileostomies following restorative proctocolectomy.

Main Methods:

  • Retrospective analysis of 310 patients who underwent restorative proctocolectomy between 1976 and 1990.
  • Data collected on ileostomy-related complications before and after stoma closure.

Main Results:

  • Of 296 patients with a covering ileostomy, 5.7% experienced complications before closure, with obstruction being most common.
  • After closure, 22.4% developed complications, including small bowel obstruction (9.6%), peritonitis (1.1%), and enterocutaneous fistula (0.8%).

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  • Overall, significant complications were less frequent than in some other reported series.

    • Conclusions:

    • Temporary ileostomies are associated with a manageable rate of complications, predominantly obstruction.
    • Fistula formation is a rare complication.
    • The use of defunctioning ileostomies remains a valuable strategy in mitigating pelvic sepsis after restorative proctocolectomy.