Morbidity and mortality after the closure of a protective loop ileostomy: analysis of possible predictors.

Background/aims: A diverting loop ileostomy is often created to protect distal colorectal, coloanal and ileoanal anastomoses. Ileostomy closure is associated with somewhat morbidity and mortality. The aim of this study was to determine the morbidity and morbidity related factors of ileostomy closure.

Methodology: Prospectively recorded data of 255 patients who underwent diverting loop ileostomy between October 2000 and May 2011 were analyzed retrospectively.

Results: The study consisted of 139 male and 116 female patients with a median age of 54 years (range 17-79) who underwent ileostomy closure. The morbidity rate of ileostomy closure was 18.4% (47 patients) and the mortality rate was 1.2% (3 patients). When patients with morbidity and without morbidity were compared in terms of gender; age, American Society of Anesthesiology Score, primary pathology, surgeon factor; setting of ileostomy creation and time to stoma closure, only American Society of Anesthesiology Score was found as a predictor for morbidities.

Conclusions: Closure of loop ileostomy is a simple procedure with low morbidity and a small but significant risk of mortality. Surgeons must consider the known risks in conjunction with the overall benefit/risk analysis before deciding between a temporary fecal diversion and a discontinuous colonic resection.