Loop ileostomy is a safe option for fecal diversion
- 1 April 1993
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Diseases of the Colon & Rectum
- Vol. 36 (4), 349-354
- https://doi.org/10.1007/bf02053937
Abstract
This study was undertaken to prospectively assess all morbidity and mortality associated with temporary loop ileostomy. Eighty-three consecutive patients of a median age of 45 years required temporary fecal diversion after either ileoanal or low colorectal anastomosis (n = 72), for perianal Crohn's disease (n = 5), or for other reasons (n = 6). All loop ileostomies were supported with a rod, and fecal diversion was maintained for a mean of 10 weeks. To date, 67 patients have had re-establishment of intestinal continuity. Stoma closure was affected through a parastomal incision in 64 patients; in three, a laparotomy was required. The closure was stapled side to side in 49 patients, while a hand-sewn anastomosis was done in the other 18 patients; all skin wounds were left open. The mean length of surgery for ileostomy closure was 56 minutes, and the mean hospital stay was five days. Nine patients (10.8 percent) developed 10 complications, nine of which required hospitalization. Specifically, four patients developed dehydration and electrolyte abnormalities secondary to high stoma output, and two had anastomotic leaks that spontaneously healed following conservative management. One patient developed a superficial wound infection that spontaneously drained itself. One patient developed a partial small bowel obstruction that resolved without surgery after a four-day hospitalization. One stoma retracted after supporting rod removal and prompted premature closure. There was no stomal ischemia, hemorrhage, prolapse, or mortality in this series. Thus, loop ileostomy is a safe way to achieve fecal diversion.Keywords
This publication has 23 references indexed in Scilit:
- Assessment of the defunctioning efficiency of the loop ileostomyDiseases of the Colon & Rectum, 1991
- The double-stapled ileal reservoir and ileoanal anastomosisDiseases of the Colon & Rectum, 1991
- Long-term functional analysis of the ileoanal reservoirDiseases of the Colon & Rectum, 1989
- Loop ileostomy for complete fecal diversion following colectomy and ileoanal anastomosisDiseases of the Colon & Rectum, 1988
- The ileal reservoir and ileoanal anastomosis procedureDiseases of the Colon & Rectum, 1988
- The outcome of loop ileostomy closure in 293 casesInternational Journal of Colorectal Disease, 1987
- Ileal Pouch-Anal Anastomosis for Chronic Ulcerative ColitisAnnals of Surgery, 1987
- Restorative proctocolectomy: The four loop (W) reservoirBritish Journal of Surgery, 1987
- Temporary ileostomy for ileal pouch-anal anastomosisDiseases of the Colon & Rectum, 1986
- Ileoanal Reservoir for Ulcerative Colitis and Familial PolyposisArchives of Surgery, 1986