Comparative Study Between Hand-Sewn Loop Ileostomy Closure Versus Side-To-Side Stapler Anastomosis Closure Of Loop Ileostomy In A Teaching Institute Of India

Abstract

Loop ileostomy is a commonly performed procedure for various surgical operations and is now gaining on conventional loop colostomy. There are different methods of loop ileostomy closure. This study was carried out to compare hand-sewn loop ileostomy closure and stapler anastomosis side-to-side closure. AIMS: To compare both types of closure in terms of operative time, patientshospital stay, postoperative complications like anastomosis leak, postoperative intestinal obstruction etc., and finally cost effectiveness. MATERIALS AND METHODS: This study was carried out in 50 patients of loop ileostomy closures. Twenty Five (25) patients were taken in each type of closure selected randomly and outcome was compared for parameters like operative time, postoperative complications like anastomosis leak and postoperative obstruction, hospital stay and cost effectiveness. RESULTS: The average operative time for the hand-sewn group was 51 minutes and for the stapler group it was 42 minutes. Anastomotic leak or fistula formation occurred in 4% and small bowel obstruction occurred in 8 % of patients of the hand sewn group and in none of the stapler group. The average duration of hospital stay for the stapler group was 8 days and for the hand-sewn group it was 9 days. However, cost was significantly higher in the stapler anatomosis group. SUMMARY AND CONCLUSION: It was evident that stapler closure was more effective than hand-sewn loop ileostomy closure in prevention of postoperative complications; however, cost was a major factor against it.