Abstract
Abstract Aims Defunctioning loop ileostomy is commonly undertaken in <40% of anterior resections especially mid and low rectal cancer resections. Loop ileostomy allows early enteral nutrition and rehabilitation and reduces the impact of post operative ileus, anastomotic leaks and pelvic sepsis complications Closure of loop ileostomy is usually advocated after 3 months of the index malignant colorectal resection. The aim of this study was to assess the reversal intervals and delays in ileostomy reversal. Methods This is a cohort study carried out since January 2008 to December 2023 at a single centre. Descriptive demography & surgical outcomes were evaluated for all Anterior Resections with loop ileostomy. All anterior resections without covering loop ileostomy carried out since 2008 were recruited as controls. Results AR loop ileostomy (n = 152) AR no stoma (n = 297) Mann Whitney U (p test) Age(yrs) 67.0 ± 0.8 68.4 ± 0.7 NS Sex(M:F) 96 : 56 180 : 117 NS ASA(median) 2 2 NS BMI 26.5 ± 0.4 27.2 ± 0.3 NS Lap : Open(n) 94 : 58 220 : 77 < 0.05 Op time(mins) (index op) 256.3 ± 6.8 219.2 ± 4.7 < 0.0001 LOS(days)(index op) 10 ± 4.5 6 ± 3 Reversal (n) 111 Days to reversal 262 ± 102 Reverse op time(mins) 84.3 ± 4.9 LOS reversal(days) 6 ± 3.5 Conclusion Delays in loop ileostomy reversal in our intuition were due to: progressive CRC disease diagnosis, adjuvant treatments, patient frailty/death, patient choice, delays in anastomotic integrity checks, & theatre availability. To avoid delay, reversal should be planned at time of defunctioning loop ileostomy.
Published Version
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