Does the timing of loop ileostomy closure affect outcome: A case-matched study.

Introduction: The optimal timing for the closure of loop ileostomies remains controversial. The aim of this study is to determine whether ileostomy closure (<3 months post formation) affects stoma-related morbidity compared to late closure (≥3 months post formation).

Methods: All patients who had loop ileostomy and ileostomy closure between 2012 and 2015 were identified from an IRB-approved, prospectively maintained institutional database.The patients who underwent ileostomy closure (<3 months) were compared against matched patients undergoing ileostomy closure (≥3 months). The outcomes for the two groups were compared.

Results: A total of 358 patients were analyzed. Mean age was 46 ± 17 years. There were 179 patients in each group [ileostomy closure (<3 months) and ileostomy closure (≥3 months)]. Both groups were matched. Groups were comparable in preoperative characteristics and demographics. All of the peri-operative variables were comparable. No difference was observed in estimated blood loss (EBL), operative time (OT) and length of stay (LOS) (all p > 0.05). Postoperative outcomes including wound infection, post-operative bleeding, intra-abdominal abscess, ileus, small bowel obstruction (SBO), anastomotic leak, reoperation, surgery related readmission, postoperative transfusion were also similar among the groups (p > 0.05).

Conclusions: Ileostomy closure (<3 months) is practical and safe. It does not increase morbidity and significantly reduces the time patient has a stoma. This may be advantageous in regards to having a reduced possibility of stoma related complications.