Comparison of complication rates after early and late closure of loop ileostomies: A retrospective cohort study.

IF 1.7 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY
Pırıltı Özcan, Özgül Düzgün
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Abstract

Background: In the treatment of rectal cancer, a temporary loop ileostomy (TLI) is created after low anterior resection to protect bowel function in the postoperative period. Dehydration and kidney failure are significant potential complications in loop ileostomies. Compared to late closure (3-6 months), early closure (10-14 days) of the TLI may facilitate faster patient recovery and shorter hospital stays.

Aim: To compare early and late closure of TLIs and demonstrate that early stoma closure can be performed without increasing morbidity.

Methods: This study included patients who underwent TLI for rectal cancer, with data collected prospectively between June 2016 and October 2024 and analyzed retrospectively. Patients whose stomas were closed in the late period (3-6 months) between June 2016 and October 2022 (group A) were compared with those who underwent early closure (10-14 days) between October 2022 and 2024 (group B), with the primary outcome being complication rate and the secondary outcome being quality of life.

Results: A total of 270 TLIs were created (70.9%). Of these, 120 (44.4%) were closed in the late period (group A), and 150 (55.6%) were closed in the early period (group B). There was no statistically significant difference between group A and group B in terms of demographic and clinicopathological characteristics (P > 0.05). Perioperative (anesthesia management, operative time, blood loss, surgical technique) and postoperative findings (anastomotic leak, infection) were similar between the two groups and were not statistically significant (P > 0.05). There were no statistically significant differences in complication rates as the primary outcome between the two groups. Quality of life as a secondary outcome was significantly higher in the early closure group (P < 0.05).

Conclusion: No statistically significant difference was found between early and late loop ileostomy closure in terms of perioperative and postoperative morbidity. Early closure accelerated patients' psychological and social recovery.

Abstract Image

一项回顾性队列研究:早期和晚期回肠造口术后并发症发生率的比较。
背景:在直肠癌的治疗中,在低位前切除术后建立临时回肠袢造口术(TLI)以保护术后肠功能。脱水和肾衰竭是环形回肠造口术的重要潜在并发症。与晚期关闭(3-6个月)相比,TLI的早期关闭(10-14天)可促进患者更快康复和缩短住院时间。目的:比较早期和晚期TLIs的闭合,证明早期闭合不增加发病率。方法:本研究纳入2016年6月至2024年10月期间接受直肠癌TLI治疗的患者,前瞻性收集数据并进行回顾性分析。将2016年6月至2022年10月晚期(3-6个月)闭合造口的患者(A组)与2022年10月至2024年早期(10-14天)闭合造口的患者(B组)进行比较,主要结局为并发症发生率,次要结局为生活质量。结果:共创建tli 270个,占70.9%。其中后期结案120例(44.4%),前期结案150例(55.6%)。A组与B组在人口学及临床病理特征方面比较,差异无统计学意义(P < 0.05)。两组围手术期(麻醉处理、手术时间、出血量、手术技术)及术后表现(吻合口漏、感染)相似,差异无统计学意义(P < 0.05)。两组间以并发症发生率为主要预后指标的差异无统计学意义。早期闭合组的生活质量作为次要指标显著高于对照组(P < 0.05)。结论:早期和晚期回肠造口术围手术期和术后发病率无统计学差异。早期关闭加速了患者的心理和社会恢复。
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