Early closure compared to late closure of temporary ileostomy in rectal cancer: a randomized controlled trial study

Abstract

A temporary loop ileostomy is one of the most common methods for the prevention of anastomotic leakage in rectal cancer patients who underwent low anterior resection. However, the optimal timing of loop ileostomy reversal remains unknown. The main purpose of this study is to assess the suitable time for a reversal of temporary loop ileostomy in rectal cancer patients. MethodsWe conducted a prospective, randomized trial at Sina Hospital, Tehran, Iran from 2020 to 2021 to determine the appropriate time for closure of temporary loop ileostomy in rectal cancer patients who underwent low anterior resection. ResultsThe results of this prospective randomized controlled trial are as shown: signi cantly difference in body mass index, the time interval between creation and closure of stoma, and distance from last chemotherapy. No signi cant difference was found between the two groups in terms of complications based on the Clavien-Dindo classi cation. As well as, there is no signi cant difference in perioperative outcomes, such as blood loss, operative time, re-admission, and re-operation. Also, statistically signi cant differences had reported between patients' quality of life and LARS score. ConclusionIn summary, it seems that early closure of ileostomy is generally effective and safe in reducing the risk of complications and improving quality of life in patients with rectal cancer following low anterior resection and chemotherapy (neoadjuvant and adjuvant).

Predictors of complications after prophylactic ileostomy reversal for rectal cancer: A retrospective study

“…Li et al [ 28 ] reported that early reversal of the ileostomy before 3 months was both practical and safe, allowing sufficient time to recover from the initial resection and soften intra-abdominal adhesions. Ahmadi-Amoli H et al[ 29 ] concluded that early reversal of ileostomy was not better than late reversal, and there was no significant difference between the two groups in reducing the risk of stoma complications. There were significant differences in the reported risk factors for complications after stoma reversa and no studies have analyzed the risk factors for stoma-related complications and overall postoperative complications separately.…”