Document Detail


Complications of loop ileostomy closure: a retrospective cohort analysis of 123 patients.
MedLine Citation:
PMID:  18563482     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Loop ileostomies are often formed in order to defunction distal anastomoses. The aim of this study was to review the complications following closure of loop ileostomies. METHODS: This is a retrospective case note analysis of all loop ileostomy closures performed in the Northumbria Healthcare NHS Trust (population over 500,000) over a 5-year period between 2001 and 2005. RESULTS: A total of 123 case records were reviewed. Complications occurred in 41 patients (33.3%), with 9 patients (7.3%) requiring further intervention. There were 4 (3.3%) postoperative deaths. Complications were more common in patients with increased comorbidity (p = 0.0007) and postoperative death was more frequent among the elderly (p = 0.0006). Postoperative death was more common in those patients who had their stomas created during surgery (elective or emergency) for diverticular disease (3 patients, p = 0.006). Patients with diverticular disease had significantly higher comorbidity and peritoneal contamination at the time of primary surgery. Ileostomy reversal after anterior resection for cancer was associated with a lower complication rate than the rest of the cohort (26%, p = 0.0003) but there was no significant difference in mortality. Neither the grade of the surgeon, the case volume, or the anastomotic technique affected postoperative morbidity. Reoperation was more common in patients whose closure procedure took less time (p = 0.002) and in those who had a shorter wait from creation to reversal of the stoma (p < 0.0001). CONCLUSIONS: Reversal of loop ileostomy may be associated with significant morbidity and mortality. Increasing the delay from creation to closure may result in fewer complications.There is an increased risk in older patients with more comorbidity, particularly when the primary procedure is for diverticular disease with significant peritoneal contamination.
Authors:
S D Mansfield; C Jensen; A S Phair; O T Kelly; S B Kelly
Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  World journal of surgery     Volume:  32     ISSN:  0364-2313     ISO Abbreviation:  World J Surg     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-18     Completed Date:  2009-01-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2101-6     Citation Subset:  IM    
Affiliation:
Department of General Surgery, North Tyneside General Hospital, Rake Lane, North Shields, Tyne and Wear, NE29 8NH, UK. steve_mansfield@btopenworld.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Chi-Square Distribution
England / epidemiology
Female
Humans
Ileostomy / methods*
Male
Middle Aged
Postoperative Complications / epidemiology*
Retrospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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