title: Ileostomy formation does not prolong hospital length of stay after open anterior resection when performed within an enhanced recovery programme.
abstract: OBJECTIVE
  Previous studies have implicated stoma formation as an independent factor prolonging length of stay (LOS) after colorectal surgery. We examined whether loop ileostomy (LI) formation during an open anterior resection affected LOS within a newly developed enhanced recovery programme (ERP). This involved reorganization of services, including stoma care, to optimize pre- and perioperative patient education, training and expectation, while applying the standard scientific principles of enhanced recovery.
  
  
  METHODS
  Data were collected prospectively on 72 consecutive open anterior resections (33 with LI) to see whether LI affected LOS. Stomas were fashioned at the surgeon's discretion and patients were discharged according to agreed criteria.
  
  
  RESULTS
  Thirty-three of the 72 patients had a covering LI performed. The overall age range was 32-85 years (median 68), with 40 patients being men. LOS for all 72 patients ranged from 3 to 34 days. The median and mean LOS were the same for both groups (median 6 days, mean 8 days). The complication rate was 44% (32/72) with a leak rate of 7% (5/72) and a mortality of 1.4% (1/72). Between the two groups (no ileostomy vs ileostomy), there was no statistically significant difference in complications (41%vs 48%), leakage (8%vs 6%) and readmission rates (12%vs 5%).
  
  
  CONCLUSIONS
  A covering loop ileostomy need not prolong hospital stay after open anterior resection.
authors.affiliation: Colorectal Department, Wirral NHS Trust, Arrowe Park Hospital, Upton, The Wirral, UK.
authors.forename: S
authors.initials: S
authors.lastname: Hignett
authors.forename: C D
authors.initials: CD
authors.lastname: Parmar
authors.forename: W
authors.initials: W
authors.lastname: Lewis
authors.forename: C A
authors.initials: CA
authors.lastname: Makin
authors.forename: C J
authors.initials: CJ
authors.lastname: Walsh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007081:Ileostomy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000601:surgery*; D012007:Rectum / Q000601:surgery