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Comparison of early versus delayed closure of ileostomy in a tertiary care hospital

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Research Paper 01/12/2020
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Comparison of early versus delayed closure of ileostomy in a tertiary care hospital

Abid Rafiq, Abdul Ghaffar, Saeed Mahmood, Muhammad Kareemullah, Shamsuddin, Saqib U Khan, Maheen Qasim, Afsar Ali Bhatti
Int. J. Biosci.17( 6), 70-75, December 2020.
Certificate: IJB 2020 [Generate Certificate]
Key: Anastomotic leakDelayed closure of ileostomyEarly closure of ileostomyPost-operative complicationsWound infection

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.

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