Evaluation of the Causal Factors of Complications Following Ileostomy Closure
Causal Factors of complications following ileostomy closure
DOI:
https://doi.org/10.54393/pbmj.v5i5.444Keywords:
anastomotic leak, ileostomy closure and ileostomy stromaAbstract
To estimate the causative factors of complications in ileostomy reversal. This study was conducted at the Department of Surgery Khairpur Medical College Khairpur Mirs from January 2021 to December 2021. Methods: This analysis comprised 52 patients selected consecutively who underwent ileostomy reversal within one year. The study excluded patients under 12 years of age. All patients were followed weekly for three months. The main measure of outcome was the occurrence of surgical complications within 30 days of resolution. Results: 52 total patients of ileostomy closures were analyzed to evaluate features contributory to mortality and morbidity. There was no death in this study, but the complication ratio was 15.4% (8 patients), the most common complications were leakage of anastomosis 4 (7.7%), infection of wound 2 (3.8%) and intestinal obstruction 2 (3.8%). The anastomotic site closure technique, primary stoma closure, surgeon's experience and stoma type were important contributing factors. Conclusions: We determined that ileostomy closure is related with several problems but not cause any death. The techniques of closure of the anastomotic site, the surgeon's experience, the type of stoma and the technique of closure of skin were forecasters of complications
References
Baik H, Bae KB. Low albumin level and longer interval to closure increase the early complications after ileostomy closure. Asian journal of surgery. 2021 Jan 1;44(1):352-7. doi.org/10.1016/j.asjsur.2020.09.007
Garfinkle R, Savage P, Boutros M, Landry T, Reynier P, Morin N, et al. Incidence and predictors of postoperative ileus after loop ileostomy closure: a systematic review and meta-analysis. Surgical Endoscopy. 2019 Aug;33(8): 2430-43.doi.org/10.1007/s00464-019-06794-y
Vergara-Fernández O, Trejo-Avila M, Salgado-Nesme N. Multivariate analysis of risk factors for complications after loop ileostomy closure. Cirugia y cirujanos. 2019 Jun 14;87(3):337-46. doi.org/10.24875/CIRU.18000611
Rombey T, Panagiotopoulou IG, Hind D, Fearnhead NS. Preoperative bowel stimulation prior to ileostomy closure to restore bowel function more quickly and improve postoperative outcomes: a systematic review. Colorectal Disease. 2019 Sep;21(9):994-1003. doi.org/10.1111/codi.14636
Yellinek S, Krizzuk D, Gilshtein H, Djadou TM, de Sousa CA, Qureshi S, et al. Early postoperative outcomes of diverting loop ileostomy closure surgery following laparoscopic versus open colorectal surgery. Surgical Endoscopy. 2021 Jun;35(6):2509-14. doi.org/10.1007/s00464-020-07662-w
Lee KH, Kim HO, Kim JS, Kim JY. Prospective study on the safety and feasibility of early ileostomy closure 2 weeks after lower anterior resection for rectal cancer. Annals of Surgical Treatment and Research. 2019 Jan 1;96(1):41-6. doi.org/10.4174/astr.2019.96.1.41
Slieker J, Hübner M, Addor V, Duvoisin C, Demartines N, Hahnloser D. Application of an enhanced recovery pathway for ileostomy closure: a case–control trial with surprising results. Techniques in coloproctology. 2018 Apr;22(4):295-300. doi.org/10.1007/s10151-018-1778-1
Bhama AR, Batool F, Collins SD, Ferraro J, Cleary RK. Risk factors for postoperative complications following diverting loop ileostomy takedown. Journal of Gastrointestinal Surgery. 2017 Dec;21(12):2048-55. doi.org/10.1007/s11605-017-3567-y
Li W, Ozuner G. Does the timing of loop ileostomy closure affect outcome: A case-matched study. International Journal of Surgery. 2017 Jul 1; 43:52-5. doi.org/10.1016/j.ijsu.2017.05.039
Choi YJ, Kwak JM, Ha N, Lee TH, Baek SJ, Kim J, et al. Clinical outcomes of ileostomy closure according to timing during adjuvant chemotherapy after rectal cancer surgery. Annals of Coloproctology. 2019 Aug;35(4):187. doi.org/10.3393/ac.2018.10.18.1
Lee JH, Ahn BK, Lee KH. Complications Following the Use of Biologic Mesh in Ileostomy Closure: A Retrospective, Comparative Study. Wound management & prevention. 2020 Jun 1;66(6):16-22.
Farag S, Rehman S, Sains P, Baig MK, Sajid MS. Early vs delayed closure of loop defunctioning ileostomy in patients undergoing distal colorectal resections: an integrated systematic review and meta‐analysis of published randomized controlled trials. Colorectal Disease. 2017 Dec;19(12):1050-7. doi.org/10.1111/codi.13922
Bausys A, Kuliavas J, Dulskas A, Kryzauskas M, Pauza K, Kilius A, et al. Early versus standard closure of temporary ileostomy in patients with rectal cancer: a randomized controlled trial. Journal of surgical oncology. 2019 Aug;120(2):294-9. doi.org/10.1002/jso.25488
Nguyen JM, Bouchard-Fortier G, Covens A. Same-day discharge of Gynecologic Oncology patients following ileostomy closure is feasible and safe. Gynecologic Oncology. 2020 Feb 1;156(2):446-50. doi.org/10.1016/j.ygyno.2019.11.014
Abdalla S, Scarpinata R. Early and late closure of loop ileostomies: a retrospective comparative outcomes analysis. Ostomy Wound Manage. 2018 Dec 1;64(12):30-5. doi.org/10.25270/owm.2018.12.3035
Whitney S, LaChapelle C, Plietz M, George J, Khaitov S, Greenstein A. Unexplained systemic inflammatory response following ileostomy closure after ileal pouch-anal anastomosis: a deeper dive into a rare entity. International Journal of Colorectal Disease. 2020 Dec;35(12): 2267-71.doi.org/10.1007/s00384-020-03710-y
Sun Z, Zhao Y, Liu L, Qin J. Clinical Outcomes of Ileostomy Closure before Adjuvant Chemotherapy after Rectal Cancer Surgery: An Observational Study from a Chinese Center. Gastroenterology Research and Practice. 2021 Jul 14;2021. doi.org/10.1155/2021/5592721
Richards SJ, Udayasiri DK, Jones IT, Hastie IA, Chandra R, McCormick JJ, et al. Delayed ileostomy closure increases the odds of Clostridium difficile infection. Colorectal Disease. 2021 Dec;23(12): 3213-9.doi.org/10.1111/codi.15858
Zhen L, Wang Y, Zhang Z, Wu T, Liu R, Li T, et al. Effectiveness between early and late temporary ileostomy closure in patients with rectal cancer: A prospective study. Current Problems in Cancer. 2017 May 1;41(3):231-40. doi.org/10.1016/j.currproblcancer.2017.02.007
Brown SR, Khan B, Green HJ, Beck DE. Overall survival associated with ileostomy closure in patients with rectal cancer before and after adjuvant therapy. Ochsner Journal. 2017 Dec 21;17(4):328-30.
Dukes’ Club Research Collaborative, Chambers A, Stearns A, Walsh A, Rankin A, Khan A, Morton A, Engledow A, Newman A, Shaw A, Wilkins A. Factors impacting time to ileostomy closure after anterior resection: the UK closure of ileostomy timing cohort study (CLOSE‐IT). Colorectal Disease. 2021 May;23(5):1109-19.
Vaughan-Shaw PG, Gash K, Adams K, Vallance AE, Pilkington SA, Torkington J, et al. Protocol for a multicentre, dual prospective and retrospective cohort study investigating timing of ileostomy closure after anterior resection for rectal cancer: The CLOSurE of Ileostomy Timing (CLOSE-IT) study. BMJ open. 2018 Oct 1;8(10): e023305. doi.org/10.1136/bmjopen-2018-023305
Pedrazzani C, Secci F, Fernandes E, Jelovskijs I, Turri G, Conti C, et al. Early ileostomy reversal after minimally invasive surgery and ERAS program for mid and low rectal cancer. Updates in Surgery. 2019 Sep;71(3):485-92.doi.org/10.1007/s13304-018-0597-2
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Pakistan BioMedical Journal
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments editor@pakistanbmj.com