Evaluation of the Causal Factors of Complications Following Ileostomy Closure

Objective: To estimate the causative factors of complications in ileostomy reversal. This study was conducted at the Department of Surgery

rst indication reduces the risk of surgery, it is associated with some morbidity and mortality after con nement.Regarding complications, the testi ed studies display contradictory outcomes [11].Thus, incidence ratio after temporary stoma closure ranges from 2.4% to 48.2%.After stoma closure, the most common surgical complications are wound infection, anastomotic leakage, paralytic ileus, bleeding, and small bowel obstruction [12].Various patient and procedure related risk factors persuading stoma closure complications.These complications affect the patient's health and increase the postoperative hospital stay and hospitalization costs.
ileostomy and an end ileostomy with a distant mucous stula.(Table 1) 52 subsequent patients whose ileostomy was closed after eight weeks of ileostomy were enrolled in the analysis.The study excluded patients under 12 years of age, patients who were closed within 6 weeks, and patients who had undergone additional unrelated surgery.The temporary ileostomy indications, demographics of patients and surgery particulars were recorded.A distal barium loopogram was accomplished in all subjects before closure.Oral feeding was discontinued the day before surgery, and routine bowel preparation of the distal and proximal parts of the intestine, lavage with an orally administered mannitol solution prior to surgery, and lavage of the distal parts with saline were performed.For 5 days, all patients were given parenteral antibiotics (ceftriaxone and metronidazole).All patients were required to provide their informed permission to a laparotomy.The stoma was mobilized from the adjacent peritoneal and fascial adhesions using an elliptical circumstomal incision.After freshening the enterotomy margins and splitting the mesenteric side integral and the transversely closed enterotomy, a delayed absorption suture was employed with a hand stitched extra-mucosal in interrupted single layer method.Interrupted prolene 0 stitches were used to close the muscle gap.All skin wounds were closed with 2/0 interrupted prolene, and a sterile dressing was used as needed.Complications were evaluated during the hospital stay and in weekly surveillance for three months after release.Surgical complications included anastomotic leaking, paralytic ileus, and wound infections.Several risks associated with the surgery have been identi ed.As a consequence, after 30 days, there were no di culties associated to the procedure.SPSS version 20 was used to analyze the data.Statistical signi cance was de ned as a p value of less than 0.05.

M E T H O D S
The intraperitoneal drainage was maintained according to the operating surgeon's decision.Corrugated drainage was used in 20 (38.5%) patients.Stoma closure 21 procedures (40.4%) were performed under direct supervision, while 31 (59.6%)closures were accomplished by surgeons.Seven days was the mean stay postoperatively (median 4, range 4-16, SD ± 2.30 days).There was no death in this study, but the complication ratio was 15.4% (8 patients), the most common complications were leakage of anastomosis R E S U L T S 52 total patients of ileostomy closures were analyzed to evaluate features contributory to mortality and morbidity.All patients experienced emergency surgery.17-83 years was the patients age range with the 43.2 years mean age, and 1.7 S.D. 33 (63.5%) subjects were males and 19 (36.5%) were females.The most communal indication for an ileostomy was exteriorization of the ileal perforation of typhoid fever 16 (30.8%).Subsequently penetrating abdominal trauma 9 (17.3%),abdominal tuberculosis 13 (25%), blunt abdominal trauma 3 (5.8%),intestinal gangrene 4 (7.7%),post-laparotomy 2 (3.8%), large bowel obstruction 4 (7.7%),ileal perforation post-abortion 1 (1.9%).In the majority of patients, the ileum was introduced as loop, followed by an illeo-colostomy, double-barrel The median period from stoma insertion to closure was 15 weeks (range 8-37, mean 14± 7.1).An elliptical periileostomy incision was used for 46 closures, with six necessitating laparotomies.All anastomoses were made in a hand sewn extra-mucosal in interrupted single layer technique was used with a delayed absorption suture.The loops were reversed by transverse closing after reshaping the edges, while in other cases a short segment of the intestine was excised and an end-to-end anastomosis was performed.The mean operative duration was 55 minutes (range 47-125 mints).

C O N C L U S I O N
It is not feasible to reverse an ileostomy without problems.However, it has been discovered that anastomotic site closure techniques, stoma type, surgeon expertise, and skin closure technique are all predictive of problems.Retrograde enterotomy, resection, and end-to-end anastomosis all have worse results than loop closures.When compared to primary skin closures, the risk of infection and wound dehiscence is reduced with delayed primary skin closures.

R E F E R E N C E S
[1] [2]

Table 1 :
Types of Ileostomies

Table 2 :
Complications following ileostomy closure are linked to

Table 3 :
Complications after ileostomy closure are linked to the operation method