Techniques and complications of ileostomy takedown

P. Terry Phang, Jon M. Hain, Javier J. Perez-Ramirez, Robert D. Madoff, Brett T. Gemlo

Research output: Contribution to journalArticlepeer-review

107 Scopus citations

Abstract

OBJECTIVE: We use a loop ileostomy for temporary fecal diversion because of ease of technical construction and assumed low complication rate. Here, we review our complications of loop ileostomy and takedown using three techniques of closure. METHODS: We reviewed charts of all patients who had temporary ileostomies constructed during 1987 to 1995 (n = 366). Ileostomy takedown was performed in 339 patients using one of three closure techniques: enterotomy suture (65%), resection with handsewn anastomosis (20%), and stapled anastomosis (15%). Complications were recorded for pre-takedown and 30-day post-takedown intervals. RESULTS: Overall complication rate was 28%. Pre-takedown complications occurred in 21 patients (5.7%), including small bowel obstruction (2.5%) and dehydration/electrolyte derangement (2.2%). Post-takedown complications occurred in 83 patients (24.5%), including wound infection (14.2%), small bowel obstruction (5%), anastomotic leak (2.9%), and 1 death from a cardiac event. Post-takedown obstruction was higher for closure using resection with sutured anastomosis (12%) compared with enterotomy suture (2.3%), P ≤0.003. Stapled anastomosis had an intermediate rate of obstruction (7.7%). Anastomotic leak was similar between closure techniques. CONCLUSIONS: Loop ileostomy and takedown are associated with low rates of serious complications (5% or less). As such, we continue to advocate use of loop ileostomy as a diversion procedure. Closure by enterotomy suture is preferred over resection. However, if resection is required, closure by stapled anastomosis is preferred over suture anastomosis.

Original languageEnglish (US)
Pages (from-to)463-466
Number of pages4
JournalAmerican journal of surgery
Volume177
Issue number6
DOIs
StatePublished - Jun 1999

Bibliographical note

Copyright:
Copyright 2007 Elsevier B.V., All rights reserved.

Fingerprint Dive into the research topics of 'Techniques and complications of ileostomy takedown'. Together they form a unique fingerprint.

Cite this