Short-term Outcome of Early Closure of Diverting Loop Ileostomy in Patients with Emergency Benign Colo-rectal Pathologies

Document Type : Original Article

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Department of General Surgery, Faculty of Medicine, Benha University, Benha, Egypt

Abstract

Aim of work: To investigate the short-term outcome of early closure of loop ileostomy in cases diverted for
emergency benign indications after distal colectomies and primary anastomosis.
Patients and methods: The present prospective randomized controlled study included 62 patients presented
with non-malignant distal gastrointestinal emergencies including obstruction, and destructive trauma who were
randomly allocated into two groups.
Group A included 31 patients: who underwent early revision for the simple loop ileostomy 3 weeks after the
primary intervention.
Group B included 31 patients who underwent early revision for the simple loop ileostomy 3 months after the
primary intervention.
Follow-up was planned for a month for any evolving complications including wound complications (Midline and
stoma site), unexplained abdominal pain (Suspicious for anastomotic leakage), ileus, unexplained fever, and oral
intake intolerance.
Results: The mean age was 36.4±5.3 and 37.2±4.7 years for groups A and B respectively. The main cause of
the primary intervention was sigmoid injuries followed by rectal injuries in both groups. There was a statistically
significant higher rate of post-reversal ileus in Group B (p=0.001*). The incidence of stomal complications including
peristomal infections, mucosal sloughing, stoma retraction, and parastomal hernias were higher in Group B.
Conclusion: Within carefully tailored selection criteria, patients with diverting loop ileostomy protecting a distal
colonic anastomosis after colonic resection for emergency non-malignant indications can have their ileostomies
reversed early.

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