Comparison of early versus delayed closure of ileostomy in a tertiary care hospital
Paper Details
Comparison of early versus delayed closure of ileostomy in a tertiary care hospital
Abstract
A stoma is an artificial opening made in the bowel to exteriorize the bowel contents. There are two surgical strategies for the closure of a stoma, early and delayed. Early closure of the temporary stoma might reduce both stoma-related complications and patient ailment. Wound complications are common but there are many associated morbidities due to delay in closure. An experiment was done to compare early versus delayed closure of ileostomy in a tertiary care hospital. It was conducted in the Department of Surgery, Lahore General Hospital for Six months i.e. from 21.05.2016 to 20.11.2016 with a Randomized Controlled Trial. Patients were divided into two groups. In group A, patients underwent early closure while in group B, patients underwent delayed closure. Early closure is done within one month of stoma formation whereas delayed closure after 2 months. After discharge, patients were followed-up in OPD for 90 days. Two groups were compared in terms of having complications i.e. anastomotic leakage and wound infections. Anastomotic leak and wound infection were found to be significantly higher in Group-B patients (Delayed closure) as compared to Group-A (Early closure) patients, i.e. anastomotic leak [Group-A: 13.3% vs. Group-B: 32.4%, p-value= 0.001] & wound infection [Group-A: 13.3% vs. Group-B: 36.2%, p-value= 0.000]. The outcome of early closure of ileostomy is more effective than delayed closure in terms of anastomotic leakage and wound infection.
Ahmad QA, Saeed MK, Muneera MJ, Ahmed MS, Khalid K. 2010. Indications and complications of intestinal stomas–A tertiary care hospital experience. Biomedica 26(11), 144-47.
Afridi SS, Ahmed N, Zarin M, Muslim M, Aurangzeb M. 2013. Outcome of loop ileostomy reversal: a prospective study. Khyber Med Uni J 5(3), 128-31.
Baraza W, Wild J, Barber W, Brown S. 2010. Postoperative management after loop ileostomy closure: are we keeping patients in hospital too long? Ann Royal Coll Surg England 92(1), 51.
Ahmad M, Alam S, Ahmad Z, Akhtar M, Hussain M, Uzair M. 2013. Comparison of primary versus secondary closure of ileostomy. Gomal Journal of Medical Sciences 11(1), 63-7.
Alves A, Panis Y, Lelong B, Dousset B, Benoist S, Vicaut E. 2008. Randomized clinical trial of early versus delayed temporary stoma closure after proctectomy. British Journal of Surgery 95(6), 693-8.
Khan N, Bangash A, Hadi A, Ahmad M, Sadiq M. 2011. Is early closure of stoma warranted in the management of temporary loop ileostomy? J Postgrad Med Inst 24(4), 295-300.
Omundsen M, Hayes J, Collinson R, Merrie A, Parry B, Bissett I. 2012. Early ileostomy closure: is there a downside? ANZ journal of surgery 82(5), 352-4.
Bakx R, Busch OR, Van Geldere D, Bemelman WA, Slors JFM, Van Lanschot JJB. 2003. Feasibility of early closure of loop ileostomies. Diseases of the colon & rectum 46(12), 1680-4.
Amna Shahab MAR, Muhammad Mudassar Mahmood. 2016. Outcome of Early Versus Delayed Stoma Closure. PJMHS 10(2), 534.
Lasithiotakis K, Aghahoseini A, Alexander D. 2016. Is Early Reversal of Defunctioning Ileostomy a Shorter, Easier and Less Expensive Operation? World journal of surgery 40(7), 1737-40.
Jordi-Galais P, Turrin N, Tresallet C, Nguyen-Thanh Q, Chigot JP, Menegaux F. 2003. Early closure of temporary stoma of the small bowel. Gastroentérologie Clinique et Biologique 27(8-9), 697-9.
Gooszen H. Outcome of Temporary Stomas. 2002. A Prospective Study of Temporary Intestinal Stomas Constructed between 1989 and 1996 with Invited Commentary. DIGESTIVE SURGERY-BASEL-19(1), 45-51.
Bakx R, Busch O, Bemelman W, Veldink G, Slors J, Van Lanschot J. 2004. Morbidity of temporary loop ileostomies. Digestive surgery 21(4), 277-81.
Tang CL, Seow-Choen F, Fook-Chong S, Eu KW. 2003. Bioresorbable adhesion barrier facilitates early closure of the defunctioning ileostomy after rectal excision. Diseases of the colon & rectum 46(9), 1200-7.
Abid Rafiq, Abdul Ghaffar, Saeed Mahmood, Muhammad Kareemullah, Shamsuddin, Saqib U Khan, Maheen Qasim, Afsar Ali Bhatti, 2020. Comparison of early versus delayed closure of ileostomy in a tertiary care hospital. Int. J. Biosci., 17(6), 70-75.
Copyright © 2020 by the Authors. This article is an open access article and distributed under the terms and conditions of the Creative Commons Attribution 4.0 (CC BY 4.0) license.