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Ann Surg Treat Res. 2019 Jan;96(1):41-46. English. Original Article. https://doi.org/10.4174/astr.2019.96.1.41
Lee KH , Kim HO , Kim JS , Kim JY .
Department of Surgery, Chungnam National University Hospital, Daejeon, Korea. jkim@cnu.ac.kr
Department of Surgery, Kangbuk Samsung Hospital, Seoul, Korea.
Abstract

Purpose

Transient loop ileostomies in rectal cancer surgery are generally closed after 2 or more months to allow adequate time for anastomotic healing. Maintaining the ileostomy may cause medical, surgical, or psychological complications; it also reduces the quality of life, and increase treatment costs. We performed this study to evaluate the safety and feasibility of early ileostomy closure 2 weeks postoperatively.

Methods

If a patient who underwent total mesorectal excision had 2 or more risk factors for anastomotic leakage, a loop ileostomy was created. After confirmation of intact anastomosis via sigmoidoscopy and proctography 1 week postoperatively, the patient was enrolled and ileostomy was closed 2 weeks postoperatively. The primary endpoint was the frequency of complication after ileostomy repair.

Results

Thirty patients were enrolled in the study and 6 were excluded due to anastomotic leakage. Except for 1 case of wound infection (4.2%), no patient experienced any complication including newly developed leakage after the ileostomy closure. The mean duration to repair was 13.1 days (range, 8–16 days) and mean duration to the start of adjuvant treatment after radical surgery was 5.37 weeks (range, 3.0–8.1 weeks).

Conclusion

Transient loop ileostomy, which is confirmed to be intact endoscopically and radiologically, can be safely closed 2 weeks postoperatively without requiring a significant delay in adjuvant chemotherapy.

Copyright © 2019. Korean Association of Medical Journal Editors.