The outcome of loop ileostomy closure in 293 cases

Abstract

Our experience with closure of loop ileostomies between the years 1975-1986 was reviewed. Ninety-three percent of stoma closures were done by simple transverse suture. The overall complication rate was 17%. Of the early postoperative complications (13%), the major complication was small bowel obstruction especially in patients where the stoma was protecting a pelvic ileal reservoir. Abdominal septic complications (postclosure) were rare (1%). These were generally caused by unrecognized enteric tears during the mobilization of the stoma rather than anastomotic leakage. A careful operative technique is required. The wound infection rate after healing by both secondary intention and primary skin closure was low (3%) and mainly superficial. Only one incisional hernia was observed in the late postoperative period. In three patients a posterior rectus sheath defect at the stoma site was found incidentally at laparotomy, without clinical evidence of an incisional hernia. Closure of a loop ileostomy is a safe operation with a low morbidity. In patients with a previous total colectomy there was a significant risk of small bowel obstruction after ileostomy closure.

A Comparative Study between Santulli Ileostomy and Loop Ileostomy

“…The peri-stomal complications like skin breakdown, dermatitis, and erythema with loop ileostomy were 16%, in accordance to that reported in the literature ranging from 3-36% [17]. These problems can be transient but recurrent till ileostomy is closed and usually hamper the proper application of ileostomy appliance making management of ileostomy effluent difficult [18].…”

“…Gallstones occur with gallstone pancreatitis especially if the ileostomy closure is delayed [18]. Anastomotic leaks from ileostomy reversal site in up to 8.3% are mentioned in the literature [17,19]. The incidence of wound infection has been reported from 1.3%-18.3% while incisional hernia occurs in up to 11.9% of patients after ileostomy closure [17].…”

“…Anastomotic leaks from ileostomy reversal site in up to 8.3% are mentioned in the literature [17,19]. The incidence of wound infection has been reported from 1.3%-18.3% while incisional hernia occurs in up to 11.9% of patients after ileostomy closure [17]. All these morbidities are avoided with the use of Santulli ileostomy.…”

Risk Factors for Anastomotic Leakage After Anterior Resection for Rectal Cancer

“…35 Therefore, the use of a diverting stoma should be decided on a case-by-case basis because closure is associated with its own morbidity, with some researchers reporting an overall complication rate of ostomy closure of 17%. 36 Small-bowel obstruction, wound infection, and incisional hernia can occur because a second operation is required for closure. Also, a proportion of these patients will never have their stoma reversed.…”

A Prospective Audit of the Complications of Loop Ileostomy Construction and Takedown

“…They are used to defunction the distal bowel after low colorectal/coloanal anastomoses, for perianal Crohn’s disease, after construction of a pelvic reservoir and other miscellaneous indications [5, 6]. Low pelvic anastomoses (<6 cm from the anal verge) are associated with an increased rate of complications [7,8,9].…”