Factors associated with ostomy reversal

Abstract

Colostomy or ileostomy creation is a basic skill in the armamentarium of the general surgeon for treating complex diseases of the colon. Age, race, and type of ostomy creation are significant predictors for reversal. This data may be useful for consulting patients preoperatively regarding postoperative expectations.

Ghost ileostomy after anterior resection for rectal cancer: a preliminary experience

“…Nevertheless, the advantages of covering stoma have to be contrasted with the eventual complications related to the management of the stoma, as well as with the necessity of a reintervention of intestinal recanalization (including anastomotic complications at the stoma closure site) which is burdened by morbidity and mortality rate particularly in elderly patients and in cases of delayed stoma closure, and that anyway, independently from this, already implies an increase of costs, recoveries and/or hospital stay [6,7]. Quality of life is affected by physical and psychological lifestyle changes, especially in body image and self-concept [8].…”

Factors Affecting Closure of a Temporary Stoma

“…8,20,[29][30][31] David and coworkers 20 noted that the mean time to ostomy closure was 40 weeks among 135 patients who required postoperative chemotherapy, as compared to a mean closure time of 29.5 weeks for the 567 patients who did not require chemotherapy (P Ͻ .001). Lordan and colleagues 31 found a 197 median time to closure for 24 rectal cancer patients requiring adjuvant therapy as compared to a median time of 133 days in 26 patients who did not require adjuvant chemotherapy (P ϭ .049).…”

“…20,22,[27][28][29] For example, David and coworkers 20 compared the age of the 233 patients whose ileostomies were not closed with the mean age of 731 patients who underwent stoma closure and found that age greater than 70 years was associated with a greater likelihood of absence of closure surgery (P ϭ .041). Similarly, Kairaluoma and colleagues 26 prospectively studied 141 patients who had had temporary ostomies created in a single Finnish hospital over an 8-year period of time.…”

“…7,33,34,35 Prevalent complications include postoperative wound infection, urinary tract infection, abscess, and sepsis (especially when the bowel has perforated). Den Dulk's group 29 noted a significant association between occurrence of any postoperative surgical complication and median wait until stoma closure. Their multivariate analysis found that 173 patients who developed a postoperative complication extended the time to surgical closure of their ostomy when compared to 350 patients who were known not to have a postoperative complication (Ͻ0.0001).…”

“…2 However, multiple factors may lead to delays in scheduled closure time. 3 For example, anecdotal reports from the United Kingdom suggest that some stoma closure operations are cancelled to allow for more urgent surgical cases, or due to lack of operating room time. To identify these factors, we reviewed the literature about this topic and surveyed patients about local practice following closure of a temporary stoma.…”