Short-term outcome of loop ileostomy closure under local anesthesia: results of a feasibility study.
BACKGROUND
Loop ileostomy is an established technique for temporary deviation of bowel contents to avoid clinical anastomotic leakage, fistulas, or use of an inflamed colon. Anesthetic risks and postoperative complications of the closure operation result in a significant proportion of ileostomies that are never closed, factors that should be borne in mind when fashioning temporary stomas. We investigated loop ileostomy closure under local anesthesia as a way to avoid these problems.


METHODS
As a feasibility study, 15 successive patients underwent closure of a loop ileostomy under local anesthesia. The patients' experience of the procedure, postoperative pain, analgesia requirements, and oral intake were prospectively evaluated.


RESULTS
Procedures could be comfortably completed under safe doses of local anesthesia. Use of standard nasogastric tubes was avoided and immediately postoperatively patients were able to resume a full oral diet. Discharge was on the second postoperative day (median). Complications were paralytic ileus for two days (1 patient), anastomotic leakage (1 patient), and superficial wound infection (1 patient).


CONCLUSIONS
Reversal of loop ileostomy can be performed safely and comfortably under local anesthesia. Postoperative results compare favorably with those of routine procedures.
Haagmans
Mark J
MJ
Division of Abdominal Surgery, Department of Surgery, University Medical Centre St. Radboud, Nijmegen, The Netherlands.
Brinkert
Willem
W
Bleichrodt
Rob P
RP
van Goor
Harry
H
Bremers
André J
AJ
D000328:Adult; D000368:Aged; D000772:Anesthesia, Local; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007081:Ileostomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control; D010865:Pilot Projects; D011183:Postoperative Complications; D011446:Prospective Studies; D016896:Treatment Outcome