title: 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.
authors.affiliation: Department of Colorectal Surgery, Cleveland Clinic Foundation.
authors.forename: H D
authors.initials: HD
authors.lastname: van de Pavoordt
authors.forename: V W
authors.initials: VW
authors.lastname: Fazio
authors.forename: D G
authors.initials: DG
authors.lastname: Jagelman
authors.forename: I C
authors.initials: IC
authors.lastname: Lavery
authors.forename: F L
authors.initials: FL
authors.lastname: Weakley
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007081:Ileostomy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D013536:Suture Techniques