Defunctioning loop ileostomy and stapled side-to-side closure has low morbidity.
BACKGROUND
Low pelvic anastomoses are associated with a high leak rate. Therefore, defunctioning loop ileostomies are being increasingly fashioned to protect against the consequences of a leak. However, the reported complication rates of such stoma creation and closure is between 5.7-69%.


OBJECTIVE
To determine the outcome associated with construction and side-to-side closure of loop ileostomies in one specialist unit.


METHODS
Data were obtained from a computer audit and case note analysis.


RESULTS
Between 1994 and 1998, 71 patients (41 M, 30 F) with a median age of 51 years (range 19-88 years) had a loop ileostomy constructed for: (i) 26 ileoanal pouches; (ii) 36 left colonic and rectal resections; and (iii) 9 for other reasons. Side-to-side stoma closure was achieved using a GIA linear stapler through a parastomal incision. The median hospital stay following stoma creation was 12 days (range 7-63 days) and stoma closure was 7 days (range 6-16 days). The median time to closure was 140 days (range 10-790 days). There were no ileostomy-related deaths. There were 10 (13.8%) ileostomy-related complications, 4 following creation and 6 following closure.


CONCLUSIONS
Loop ileostomy is easy to create and close and is associated with a low morbidity. Therefore, we recommend a defunctioning ileostomy as a procedure of choice for temporary faecal diversion for complex colorectal surgery.
Amin
S N
SN
Department of Surgery, Queen's Medical Centre, Nottingham, UK. shwan1st@hotmail.com
Memon
M A
MA
Armitage
N C
NC
Scholefield
J H
JH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D003106:Colon / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007081:Ileostomy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D016737:Proctocolectomy, Restorative; D012007:Rectum / Q000601:surgery; D017792:Surgical Stapling; D016896:Treatment Outcome