Feasibility of early closure of loop ileostomies: a pilot study.
OBJECTIVE
A loop ileostomy is constructed to protect a distal anastomosis, and closure is usually performed not earlier than after two to three months. Earlier closure might reduce stoma-related morbidity, improve quality of life, and still effectively protect the distal anastomosis. This pilot study was designed to investigate the feasibility of early closure of loop ileostomies, i.e., during the same hospital admission as the initial operation.


METHODS
Twenty-seven consecutive patients with a protective loop ileostomy were included. If patient's recovery was uneventful, water-soluble contrast enema examination was performed, preferably after seven to eight days. If no radiologic signs of leakage were detected, the ileostomy was closed during the same hospital admission.


RESULTS
Twenty-seven patients (8 females; mean age, 60 years) were analyzed. Eighteen patients had early ileostomy closure on average 11 (range, 7-21) days after the initial procedure. In nine patients the procedure was postponed because of leakage of the anastomosis (n = 3), delayed recovery (n = 1), small bowel obstruction (n = 1), gastroparesis (n = 1), logistic reasons (n = 2), or irradical cancer resection followed by radiotherapy (n = 1). There was no mortality and four mild complications occurred after early closure: superficial wound infection (n = 2), intravenous-catheter sepsis (n = 1), small bowel obstruction (n = 1).


CONCLUSIONS
Closure of a loop ileostomy early after the initial operation was feasible in 18 of 27 patients and was associated with low morbidity and no mortality.
Bakx
Roel
R
Department of Surgery, Academic Medical Center, University of Amsterdam, PO Box 22700, NL-1100 DE Amsterdam, the Netherlands.
Busch
Olivier R C
OR
van Geldere
Dirk
D
Bemelman
Willem A
WA
Slors
J Frederik M
JF
van Lanschot
J Jan B
JJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000601:surgery*; D000714:Anastomosis, Surgical; D003106:Colon / Q000601:surgery*; D005260:Female; D006801:Humans; D007081:Ileostomy / Q000379:methods*; D007415:Intestinal Obstruction; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011788:Quality of Life; D012007:Rectum / Q000601:surgery*; D054047:Surgical Stomas / Q000473:pathology*; D013997:Time Factors