EARLY CLOSURE OF LOOP ILEOSTOMY: IS IT FEASIBLE AND SAFE?

A total of 144 patients of temporary loop ileostomies were treated with early closure at 4 to 6 weeks from its construction. It was found to be feasible, safe and advisable specially on select group of patients with low rate of complications and the results can be compared to classical delayed closure.METHODSThis study was carried out in Department of Surgery, Patna Medical College on patients of waiting for closure of loop ileostomies done for both in emergency and routine settings. After a careful selection of cases depending on nutritional status and absence of active infection, closure of ileostomy was done 4 to 6 weeks after the index operation. The post-operative course was closely observed and followed up.RESULTSA total of 144 patients underwent early closure at 4-6 weeks from the construction of ileostomy with the mean duration of closure of 38.2 days. In most of the patients the intestinal loops were mobilised without any significant difficulty and intestinal continuity restored with linear staplers. Most common post-operative complication was wound infection in 38.9% of cases. Other complications included prolonged ileus in 2.8% cases, enterocutaneous fistula in 5.6% and incisional hernia in 6.9% of the cases. None of the patients developed intra peritoneal collection or significant anastomotic leak requiring re laparotomy. No mortality was recorded in the study subjects. The patients were discharged from the hospital ranging from 7-23 days with the average of 9.2 days from the time of stoma closure. Overall, the results may be comparable to those of the delayed conventional closure but at the same time much more convenient to the patient.