Does the Timing of Ileostomy Closure Does not Impact the Development of Complications During Ileostomy and After Its Reversal? A Retrospective Study in A Single Colorectal Center

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Usta M. A., Çekiç A. B.

Journal of Ankara University Faculty of Medicine, vol.74, no.2, pp.183-189, 2021 (Peer-Reviewed Journal)


Objectives: A temporary diverting loop ileostomy is often performed with sphincter-preserving surgery for rectal cancer. However, optimal timing for the reversal of ileostomy is a challenging issue concerning the different cut-off periods. We aimed to evaluate the association between timing of closure and development of complications during ileostomy and after its closure.

Materials and Methods: Between January 2016 and August 2020, patients who underwent ileostomy and ileostomy closure associated with the sphincter-preserving surgery for rectum adenocarcinoma were retrospectively analyzed. Ileostomy creation for rectovaginal fistula, restorative proctocolectomy, and emergent surgery for left-sided colonic tumors, and patients without ileostomy closure for any cause were excluded. Patient demographics and clinical variables were recorded. According to ileostomy closure time, the patients were divided into two groups as <6 and ≥6 months. Complications associated with ileostomy and postoperative complications after ileostomy reversal were analyzed regarding the closure time.

Results: There were 62 patients with a mean age of 59.9±13.0 years. Ileostomy closure was performed within a median duration of five months. Ileostomy-related complications developed in 14 patients (22.6%). The mean age was significantly higher in patients with complications (p=0.027). In 24 patients (38.7%), there were ileostomy reversal-related complications. Elderly female patients with higher body mass index and more comorbid diseases were more likely to have complications following ileostomy closure (p<0.05). Although the duration of ileostomy in the complicated patients was lower than in the non-complicated patients (five vs. six months), there was no significant difference (p=0.535). There was no significant impact of the grouping based on the timing of ileostomy closure as <6 and ≥6 months on the development of complications (p>0.05).

Conclusion: Timing of ileostomy closure did not influence the ileostomy-related complications and postoperative complications. Age was a significant variable for the development of complications. Female sex, obesity, and comorbidity were associated only with ileostomy reversal-related complications.

Key Words: Ileostomy, Rectum Cancer, Postoperative Complications