Complications Following Closure of Loop Ileostomy

Mann, L. J.; Stewart, P. J.; Goodwin, Robert J.; Chapuis, Pierre; Bokey, E. L.

doi:10.1111/j.1445-2197.1991.tb00275.x

Cited by 33 publications

(29 citation statements)

References 12 publications

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“…However, high complication rates (20%-48%) have been reported in other series for both methods [1][2][3][4][5]. Other studies, including this one, have demonstrated that much lower rates (<10%) are feasible [6,8,9].…”

Section: Discussionmentioning

confidence: 88%

“…In most institutions, closure of uncomplicated cases is usually performed between 8 and 12 weeks following the primary procedure. Several series have reported sizeable complication rates irrespective of whether closure of loop ileostomies is performed by hand suture or by the stapling technique [1][2][3][4][5]. It has also been suggested that complications such as obstruction at the site of the closure may be avoided and that gastrointestinal function recovers faster [6,7] with stapling which fashions a wider, functional end-to-end anastomosis.…”

Section: Introductionmentioning

confidence: 99%

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A comparison of sutured and stapled closure of diverting loop ileostomies

Kraemer

Seow‐Choen

et al. 2000

Techniques in Coloproctology

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The use of staplers for ileostomy closure may facilitate the procedure and improve outcome by creating a wide, functional end-to-end anastomosis. We retrospectively compared 136 sutured ileostomy closures with 152 stapled closures. Perioperative data and outcome parameters were analyzed. Patient characteristics were similar in both groups. Highly significant reduction was found in operating time (p < 0.001) and hospitalization (p = 0.001) in the stapled group compared to the sutured group. Recovery of intestinal function and complication rates showed no differences. Our results show that both techniques are comparably safe but stapling is considerably faster to perform. The higher expenses of using a stapling device may be economically compensated by the shorter operation time under certain circumstances.

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Section: Discussionmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

A comparison of sutured and stapled closure of diverting loop ileostomies

Kraemer

Seow‐Choen

et al. 2000

Techniques in Coloproctology

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“…The presence of an ileostomy has also been reported to be a significant risk factor for early SBO in a report by MacLean et al on SBO following IPAA [14]. SBO following ileostomy closure is a well-recognised complication [25,26]. Thus, the use of the ileostomy as the preferred mode of proximal diversion should be further assessed in view of the high incidence of SBO.…”

Section: Discussionmentioning

confidence: 92%

Small bowel obstruction following low anterior resection: the impact of diversion ileostomy

Poon

Law

Chu

2004

Langenbecks Arch Surg

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“…This review did not find any significant difference in the incidence of intestinal obstruction between patients with loop ileostomy and with loop colostomy. However, several trials have reported that loop ileostomy is highly associated with this postoperative complication 14,[24][25][26][27][28] . Concerning postoperative bowel obstruction, there is some evidences that, with longer follow-up, adhesion-related complications might become more frequent, particularly after loop ileostomy closure 13 .…”

Section: -Outcome Measurements Relating To Stoma Closurementioning

confidence: 99%

Ileostomy or colostomy for temporary decompression of colorectal anastomosis: systematic review and meta-analysis

et al. 2008

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Purpose:The controversy regarding whether loop ileostomy or loop transverse colostomy is a better method for temporary decompression of colorectal anastomosis motivated this review. Methods: Five randomized trials were included, with 334 patients: 168 in the loop ileostomy group and 166 in the loop transverse colostomy group. The outcomes analyzed were: 1. Mortality; 2. Wound infection; 3. Time of stoma formation; 4. Time of stoma closure; 5. Time interval between stoma formation and closure; 6. Stoma prolapse; 7. Stoma retraction; 8. Parastomal hernia; 9. Parastomal fistula; 10. Stenosis; 11. Necrosis; 12. Skin irritation; 13. Ileus; 14. Bowel leakage; 15. Reoperation; 16. Patient adaptation; 17. Length of hospital stay; 18. Colorectal anastomotic dehiscence; 19. Incisional hernia; 20. Postoperative bowel obstruction. Results: Stoma prolapse was statistically significant (p = 0.00001), but with statistical heterogeneity; the sensitive analysis was applied, excluding the trials that included emergency surgery, and this showed: p = 0.02, with I 2 = 0% for the heterogeneity test. Conclusions: The outcomes reported were not statistically or clinically significant except for stoma prolapse. Better evidence for making the choice between loop ileostomy or loop colostomy requires large-scale randomized controlled trials. Key words: Ileostomy. Colostomy. Colorectal surgery. Systematic review. Meta-analysis. RESUMO Objetivo:A controvérsia entre ileostomia em alça ou colostomia em alça como a melhor forma para a descompressão temporária da anastomose colorretal motivou a realização desta revisão. Métodos: Cinco ensaios clínicos casualizados foram incluídos com 334 pacientes: 168 no grupo de ileostomia e 166 no grupo de colostomia. Os resultados analisaram: 1. Mortalidade; 2. Infecção da ferida; 3. Tempo de formação do estoma; 4. Tempo de fechamento do estoma; 5. Intervalo de tempo entre a formação e o fechamento do estoma; 6. Prolapso do estoma; 7. Retração do estoma; 8. Hérnia parastomal; 9. Fistula parastomal; 10. Estenose; 11. Necrose; 12. Irritação de pele; 13. Íleo; 14. Fístula entérica; 15. Reoperação; 16. Adaptação do paciente; 17. Tempo de internação hospitalar; 18. Deiscência da anastomose colorretal; 19. Hérnia de Incisional; 20. Obstrução intestinal pós-operatória. Resultados: Prolapso do estoma: p = 0.00001, mas com heterogeneidade estatística; a análise de sensibilidade foi aplicada excluindo os estudos que incluíram cirurgias de emergência: p = 0.02 e teste de heterogeneidade: I 2 =0%. Conclusões: Os resultados encontrados não foram estatística ou clinicamente significantes, exceto prolapso do estoma. A melhor evidência para a escolha entre ileostomia em alça ou colostomia em alça necessita de maior número de ensaios clínicos.

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Complications Following Closure of Loop Ileostomy

Cited by 33 publications

References 12 publications

A comparison of sutured and stapled closure of diverting loop ileostomies

A comparison of sutured and stapled closure of diverting loop ileostomies

Small bowel obstruction following low anterior resection: the impact of diversion ileostomy

Ileostomy or colostomy for temporary decompression of colorectal anastomosis: systematic review and meta-analysis

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