Acceptable results of early closure of loop ileostomy to protect low rectal anastomosis

TY - JOUR

T1 - Acceptable results of early closure of loop ileostomy to protect low rectal anastomosis

AU - Perdawid, Sharafaden Karim

AU - Andersen, Ole Bjørn

AU - Perdawood, Sharaf

PY - 2011/6

Y1 - 2011/6

N2 - INTRODUCTION: This was a pilot project performed prior to full implementation of early loop ileostomy closure (within two weeks) following low anterior resection of the rectum in a group of patients selected according to previously recommended criteria for safe, early ileostomy closure. MATERIAL AND METHODS: Retrospective review of medical records. Patients undergoing loop ileostomy closure between December 2009 and October 2010 were analyzed. Data were collected on demographics, tumour characteristics, information about the perioperative period, operative details, postoperative complications, closure operation, the postoperative closure period and follow-up. RESULTS: Eleven patients were included (men, n = 4) with a median age of 58 years (range 47-79 years). Ileostomy closure was performed at a median of ten days (range 8-13 days) following rectum resection. The median hospital stay was 16 days (range 14-24 days). No re-laparotomies were performed. One patient developed a pelvic pus collection ten days post closure and was treated conservatively. One patient died 32 days after closure for reasons not related to surgery. CONCLUSIONS: The results of this small retrospective study show morbidity rates associated with early loop ileostomy closure that are probably acceptable. Safety, feasibility, timing and selection criteria should be clarified in large randomized studies.

AB - INTRODUCTION: This was a pilot project performed prior to full implementation of early loop ileostomy closure (within two weeks) following low anterior resection of the rectum in a group of patients selected according to previously recommended criteria for safe, early ileostomy closure. MATERIAL AND METHODS: Retrospective review of medical records. Patients undergoing loop ileostomy closure between December 2009 and October 2010 were analyzed. Data were collected on demographics, tumour characteristics, information about the perioperative period, operative details, postoperative complications, closure operation, the postoperative closure period and follow-up. RESULTS: Eleven patients were included (men, n = 4) with a median age of 58 years (range 47-79 years). Ileostomy closure was performed at a median of ten days (range 8-13 days) following rectum resection. The median hospital stay was 16 days (range 14-24 days). No re-laparotomies were performed. One patient developed a pelvic pus collection ten days post closure and was treated conservatively. One patient died 32 days after closure for reasons not related to surgery. CONCLUSIONS: The results of this small retrospective study show morbidity rates associated with early loop ileostomy closure that are probably acceptable. Safety, feasibility, timing and selection criteria should be clarified in large randomized studies.

KW - Aged

KW - Anastomosis, Surgical

KW - Colorectal Neoplasms

KW - Female

KW - Humans

KW - Ileostomy

KW - Length of Stay

KW - Male

KW - Middle Aged

KW - Pilot Projects

KW - Postoperative Complications

KW - Postpartum Period

KW - Rectum

KW - Retrospective Studies

KW - Time Factors

M3 - Journal article

C2 - 21651876

SN - 2245-1919

VL - 58

SP - A4280

JO - Danish Medical Journal

JF - Danish Medical Journal

IS - 6

ER -