title: Ileostomy closure without contrast study is safe in selected patients.
abstract: BACKGROUND
  Following anterior resection of the rectum it is common to defunction the anastomosis with an ileostomy. Prior to closure of this, a contrast study is usually performed to check for healing. Several patients at our institution have not undergone a contrast study prior to closure. The present study aimed to compare outcome in this group with patients who had undergone contrast radiology.
  
  
  METHODS
  A retrospective review of patients undergoing anterior resection with an ileostomy was performed. We only included those patients who had a straight colorectal/coloanal anastomosis that could be examined clinically and had a smooth postoperative course with no evidence of pelvic sepsis.
  
  
  RESULTS
  Fifty-nine patients fulfilled the criteria for the study. Thirty-five patients had a contrast study. These showed two leaks and five strictures. The anastomosis was 0-7 cm from the anal verge in 31 patients (16 contrast studies). It was above 7 cm in 28 patients (19 contrast studies). No patient had pelvic sepsis after ileostomy reversal.
  
  
  CONCLUSIONS
  In patients with an ileostomy following anterior resection, with a clinically examinable anastomosis and a smooth postoperative course, a radiological examination of the anastomosis prior to ileostomy closure appears unnecessary.
authors.affiliation: South Auckland Clinical School, University of Auckland, New Zealand.
authors.forename: Timothy
authors.initials: T
authors.lastname: Cowan
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Hill
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D000714:Anastomosis, Surgical / Q000009:adverse effects; D003106:Colon / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D003287:Contrast Media; D005260:Female; D006801:Humans; D007081:Ileostomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010173:Palpation; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011859:Radiography; D012007:Rectum / Q000601:surgery*; D012189:Retrospective Studies; D012812:Sigmoidoscopy; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media