Morbidity and mortality after closure of loop ileostomy

Saha, Arin; Tapping, Charles R.; Foley, G. T.; Baker, R. P.; Sagar, P. M.; Burke, Dermot; Sue‐Ling, H. M.; Finan, P. J.

doi:10.1111/j.1463-1318.2008.01708.x

Cited by 78 publications

(72 citation statements)

References 31 publications

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“…Our series coincides with the most common closure-related complications published in the literature: intestinal obstruction, surgical wound infection, intraabdominal infections, enterocutaneous fistula and anastomotic dehiscence (3,20). We had a high complication rate, compared to other series reporting morbidities of 11.4 (3) or 33.8% (19), probably due to a more exhaustive data collection.…”

Section: Discussionmentioning

confidence: 73%

Protective ileostomy: complications and mortality associated with its closure

Mengual-Ballester

García-Marín²,

Pellicer-Franco

et al. 2012

Rev. esp. enferm. dig.

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Section: Discussionmentioning

confidence: 73%

Protective ileostomy: complications and mortality associated with its closure

Mengual-Ballester

García-Marín²,

Pellicer-Franco

et al. 2012

Rev. esp. enferm. dig.

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“…In a study by Saha et al [16], 38% of the patient had their primary operation as an emergency. No other stud- ies provided this data and therefore it was not possible to ascertain whether this is an important risk factor in occurrence of future complications.…”

Section: Resultsmentioning

confidence: 99%

“…Loffler et al [19] provide this ratio prior to exclusion of 4 patients. Six studies did not have the sex ratio compared between the 2 hand-sewn and stapled groups (Balik et al [22], Feinberg et al [8], Garcia-Botello et al [3], Phang et al [10], Saha et al [16], Wong et al [5]). …”

Section: Patient Datamentioning

confidence: 99%

Hand-Sewn versus Stapled Closure of Loop Ileostomy: A Meta-Analysis

et al. 2018

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Background: Individual trials comparing hand-sewn with stapled closure of loop ileostomy show different outcomes due to lack of statistical power. A systematic review, with a pooled analysis of results, might provide a more definitive answer. This review aimed to compare hand-sewn with stapled anastomotic technique for closure of a loop ileostomy and looked at the effect of bowel resection on the complication rates. Methodology: Relevant studies were identified from MEDLINE, EMBASE and the Cochrane database. All randomised clinical trials, prospective and retrospective studies comparing hand-sewn with stapled closure of loop ileostomy were included. Results: Of the 4,917 patients in 15 identified studies, 3,406 had hand-sewn and 1,511 stapled anastomosis. There was no difference in the rate of anastomotic leak between the hand-sewn (2.93%, 55/1,877) and the stapled group (2.08%, 25/1,202) (OR 0.81, 95% CI 0.43–1.54, p = 0.52, I² = 33%). The rate of small-bowel obstruction was higher in the hand-sewn group (7.03%, 231/3,284) compared to the stapled group (5.58%, 73/1,308; OR 0.69, 95% CI 0.51–0.92, p = 0.01, I² = 0%). There was no difference in the incidence of anastomotic leak and small-bowel obstruction in the hand-sewn anastomosis between patients with or without bowel resection. Conclusions: There was no significant difference in the rate of anastomotic leakage between the hand-sewn and stapled techniques. The rate of small-bowel obstruction was higher in the hand-sewn group. Performance of bowel resection does not significantly increase the incidence of anastomotic leak or small-bowel obstruction.

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“…Major complications occurred in 6/134 patients (4.5%), and no patient died. Other published patient series reported morbidity rates of 4–33% and mortality rates of 0–2.5% [8,9,17,18,19,20,21]. Differences between studies are mainly due to different definitions of postoperative complications; thus, a direct comparison is difficult.…”

Section: Discussionmentioning

confidence: 90%

“…On average, published intervals between primary and ileostomy closure range from 10 to 34 weeks [8,9,10,11]. Since the main aim of a loop ileostomy is to increase the safety of colorectal operations, it is important that its closure entails the least possible discomfort, morbidity, and mortality.…”

Section: Introductionmentioning

confidence: 99%

Early Closure of Ileostomy Is Associated with Less Postoperative Nausea and Vomiting

Worni¹,

Witschi²,

Gloor³

et al. 2011

Dig Surg

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Background/Aims: Temporary loop ileostomy is increasingly used in colorectal surgery but necessitates secondary closure. We evaluated postoperative complications, particularly nausea and vomiting, in patients with early, intermediate, or late elective ileostomy closure. Methods: We included all patients undergoing ileostomy closure from 2001 to 2008. Time from ileostomy construction to closure was classified as early (EC, <12 weeks), intermediate (IC, 12–18 weeks), and late (LC, >18 weeks). Using multivariable logistic regression, we compared the frequency of postoperative complications between the groups. Results: We included 134 patients (87 males; median age 71 years, range 29–91). Carcinoma of the rectum (n = 67, 50%) was the main reason for ileostomy construction. The median time to ileostomy closure was 103 days (range 8–461). Among patients with EC, IC, and LC, postoperative nausea occurred in 50.0, 73.1, and 78.6%, respectively (p = 0.006), and postoperative vomiting in 22.5, 57.7, and 59.5%, respectively (p = 0.001). Adjusting for important covariates, the odds ratio for postoperative nausea was 2.0 (95% CI 0.76–5.1) for IC and 4.1 (95% CI 1.2–14.3) for LC compared to EC (p = 0.069). For postoperative vomiting, adjusted odds ratios were 3.8 (95% CI 1.4–10.4) for IC and 4.6 (95% CI 1.4–15.5) for LC (p = 0.012). Other complications did not differ between the groups. Conclusions: These findings suggest that early ileostomy closure might reduce postoperative nausea and vomiting.

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Morbidity and mortality after closure of loop ileostomy

Abstract: Loop ileostomy closure is associated with morbidity and mortality. Anaemia and hypo-albuminaemia may be associated with poor outcome.

Cited by 78 publications

References 31 publications

Protective ileostomy: complications and mortality associated with its closure

Protective ileostomy: complications and mortality associated with its closure

Hand-Sewn versus Stapled Closure of Loop Ileostomy: A Meta-Analysis

Early Closure of Ileostomy Is Associated with Less Postoperative Nausea and Vomiting

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