Should routine contrast study be a norm before stoma reversal? A retrospective study of patients with temporary ileostomy

Abstract

In the developed nations, temporary ileostomies are usually made in order to protect a distal anastomosis after cancer surgery. However, in India and the neighbouring countries ileal perforation is the most common indication for creating a temporary ileostomy after emergency laparotomy. It seems logical to perform a contrast study when a stoma that was made to protect a bowel anastomosis is being reversed in order to check for anastomosis healing, leak or stenosis. Although we do not know precisely when and why we started this practice, it is customary at our institute to do a contrast study before reversal of a temporary ileostomy. At some institutes a routine contrast study is never done. The utility of this practice has not previously been studied at our institute. This study tries to correlate the surgeon's clinical and operative findings with the contrast study report in order to see if it may be reasonable to reverse the stoma without a routine contrast study in selected patients where the surgeon has clearly documented absence of any gross disease in the distal bowel and who have had an uneventful post-operative period. To our knowledge this appears to be the first such attempt from our country.