Abstract
Loop ileostomy closure after colorectal surgery is often associated with Postoperative ileus, with an incidence between 13–20%. The aim of this study is to evaluate the efficacy and safety of preoperative stimulation of the efferent loop with probiotics prior to ileostomy closure in patients operated on for colorectal carcinoma. For this, a prospective, randomized, double-blind, controlled study is designed. All patients who underwent surgery for colorectal carcinoma with loop ileostomy were included. Randomized and divided into two groups, 34 cases and 35 controls were included in the study. Postoperative ileus, the need for nasogastric tube insertion, the time required to begin tolerating a diet, restoration of bowel function, and duration of hospital stay were evaluated. The incidence of Postoperative ileus was similar in both groups, 9/34 patients stimulated with probiotics and 10/35 in the control group (CG) with a p = 0.192. The comparative analysis showed a direct relationship between Postoperative ileus after oncological surgery and Postoperative ileus after reconstruction surgery, independently of stimulation. Postoperative ileus after closure ileostomy is independent of stimulation of the ileostomy with probiotics through the efferent loop. There seem to be a relationship between Postoperative ileus after reconstruction and the previous existence of Postoperative ileus after colorectal cancer surgery.
Highlights
The CONSORT statement criteria were followed.One group included patients treated with stimulation of the efferent loop with probiotics prior to transit reconstruction surgery; the other control group was stimulated without giving any substance
There were no significant differences between SG and control group (CG) in terms of sociodemographic, clinical, or surgical variables (Table 1)
Based on systematic reviews about the use of probiotics as treatment of other gastrointestinal pathologies [18,19,20], we considered that this stimulation would achieve the repopulation of the excluded colon, activating the cellular absorption mechanisms, increasing motility, and decreasing efferent loop atrophy, so that after closure ileostomy, the return to normality would be faster, with a shorter time required to re-establish oral transit and tolerance, reducing the onset of postoperative ileus and the duration of hospital stay
Summary
Loop ileostomy closure after colorectal surgery is often associated with Postoperative ileus, with an incidence between 13–20%. The aim of this study is to evaluate the efficacy and safety of preoperative stimulation of the efferent loop with probiotics prior to ileostomy closure in patients operated on for colorectal carcinoma. Postoperative ileus after closure ileostomy is independent of stimulation of the ileostomy with probiotics through the efferent loop. The most common complication is postoperative ileus, with an incidence of 13–20% [4] As a result, this can lead to a significant socioeconomic impact, the worsening of a patients’ quality of life due to greater discomfort, increased risk of nosocomial infections and morbidity associated with surgery, and an increase in postoperative mortality; all of this conditioning a prolonged hospital stay and higher healthcare costs [5].
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