Ileostomy closure

Abstract

Introduction: Faecal diversion is an effective procedure to protect bowel anastomosis at high risk for leak. Loop ileostomy is more or less acceptable method for faecal diversion. Some concerns still exist regarding the risk for a significant morbidity and complications associated to ileostomy creation itself and moreover to its closure. Surgical expertise and closure techniques are considered potential factors influencing mortality. Aim of the study is to present a single institutional experience with ileostomy closures, in a high-volume training hospital, where ileostomy reversal is mainly performed by young surgeons. Methods: A retrospective study was done to evaluate data of patients who underwent loop ileostomy and ileostomy closure between June 2017 to June 2021 at Dhiraj Hospital Sumandeep Vidyapeeth , Pipariya , vadodara. Ileostomy closure was always done in hand-sewn fashion, performing either a direct closure (DC) or a resection plus end-to-end anastomosis (EEA). Postoperative morbidity was graded according to Clavien-Dindo classification. Outcomes after both methods were compared by Fisher’s exact test and Wilcoxon rank-sum test. Results: Hundred and four patients were included. Ileostomy reversal was performed by EEA in 86 patients (82.69%) and by DC in 18 patients (17.30%). Surgery was performed with a peristomal access in 93 cases (89.42%).