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Postoperative complications after closure of a diverting ileostoma—differences according to closure technique

International Journal of Colorectal Disease volume 27, pages 55–58 (2012)Cite this article

Abstract

Purpose

The aim of this study was to compare three methods for closure of a diverting ileostoma according to development of postoperative small-bowel obstruction (SBO) and anastomotic leakage (AL).

Methods

Complications arising within 30 days after closure of a defunctioning loop ileostomy in 351 patients during the period 1999–2006 were studied retrospectively by evaluation of case records. The techniques employed were: hand-sewn anastomosis without bowel resection, hand-sewn anastomosis with bowel resection and stapled anastomosis.

Results

Of the 351 patients, 149 had a hand-sewn anastomosis without bowel resection (HS), 70 had a hand-sewn anastomosis with bowel resection (HSR) and 132 patients had a stapled anastomosis (S). The total number of SBOs was 44 patients (12.5%). In the two hand-sewn groups, 15.5% (34 patients) suffered postoperative SBO compared to 7.6% (10 patients) in the stapled group (p = 0.029). No difference in AL could be found between the groups, where the overall frequency was 2.8% (10 patients). Median hospital stay was 6 days in the HS group, 5 days in the HSR group and 4 days in the S group (p = 0.001).

Conclusion

In the present study, stapled anastomosis was associated with a lower frequency of postoperative SBO and a shorter hospital stay compared to sutured anastomosis (either with or without a short small-bowel resection) after closure of a diverting ileostoma.

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Author information

Affiliations

  1. Department of Surgical Gastroenterology, Karolinska University Hospital, Huddinge, Karolinska Institutet, 141 85, Stockholm, Sweden

    Kajsa Gustavsson & Ulf Gunnarsson

  2. Department of Surgery, Karlstad Central Hospital, Karlstad, Sweden

    Pia Jestin

  3. Department of Surgical Sciences, Uppsala University, Uppsala, Sweden

    Pia Jestin

Authors
  1. Kajsa Gustavsson
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  2. Ulf Gunnarsson
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  3. Pia Jestin
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Correspondence to Kajsa Gustavsson.

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Gustavsson, K., Gunnarsson, U. & Jestin, P. Postoperative complications after closure of a diverting ileostoma—differences according to closure technique. Int J Colorectal Dis 27, 55–58 (2012). https://doi.org/10.1007/s00384-011-1287-4

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  • DOI: https://doi.org/10.1007/s00384-011-1287-4

Keywords

  • Diverting ileostoma
  • Postoperative small-bowel obstruction
  • Anastomotic leakage