Evaluation of Early Closure of Ileostomy

Abstract

Background: Ileostomy is used for surgical management of many congenital and acquired conditions of gastrointestinal tract. This study was conducted to evaluate the results of early closure of ileostomy.

Methodology: This case series was undertaken at Saidu Teaching Hospital Swat from January 2007 to January 2010. Closures were carried out with 2-3/0 vicryl (polygalectin 910) in two layers. Patients were kept in the ward postoperatively for 5-10 days, and any complication noted.

Results: The patients studied were 45; 28 males and 17 females, with male to female ratio of 1.6:1. Age range was 3-50 years. Duration of stoma was 7-40 days with average of 23.5. Three patients were operated in the same admission, the rest either in 2nd or 3rd admission. Sixteen patients had complications associated with stoma while the rest were admitted only for closure. All patients recovered from anesthesia uneventfully. Only 2 patients leaked post-operatively, both were having tuberculous abdomen, one died of sepsis and multiorgan dysfunction, and 2nd was re-explored and ileostomy refashioned. Eleven patients developed mild to moderate wound infection, among them 7 were already having skin excoriation. Three patients developed pelvic collection treated conservatively. Five patients remained in ileus for 5-8 days, kept on nasogastric suction and intravenous fluids and improved. Three patients presented later with incisional hernia.

Conclusion: Early closure of temporary loop Ileostomy is safe with low morbidity and minimal mortality and reduces the chances of stoma related complications.