Assessment of Outcomes of Ileostomy Closure versus Colostomy Closure

Abstract

Background: Small-bowel ostomies and large-bowel ostomies are two subtypes of intestinal ostomies based on the portion of the intestine that is exposed above the skin. Protecting the anastomosis from infection and keeping the peritoneum clean are critical functions of ileostomy and colostomy.

Objective: to evaluate short term outcome of ileostomy and colostomy closures to recognize which procedure is better for diversion based on the outcomes of the stoma reversal.

Methods: Two groups of 32 patients having a colostomy or an ileostomy in Zagazig University Hospitals underwent a clinical comparison of the outcomes of stoma closure. 16 patients in Group 1 had an ileostomy for reversal. Those in Group 2 who had a temporary colostomy for reversal included 10 patients with Hartmann procedure and 6 patients with simple loop stoma. During the first month, patients were seen at the outpatient clinic once a week, then once a month for the next five months.

Results: As regard intraoperative complications: Amount of blood loss was higher among Hartmann’s group (112 ±18 ml) due to severe adhesions during laparotomy compared to ileostomy group (89 ± 16 ml) and loop colostomy group (98 ± 16 ml). In terms of intraoperative blood loss, there was no statistically significant difference between ileostomy and loop colostomy, although there was a statistically significant difference between ileostomy and the Hartman procedure. In the ileostomy group, postoperative problems such as wound infection, anastomotic leakage, ileus, and intraabdominal collection were less common and more easily controlled.

Conclusion: Ileostomy closure is superior to colostomy closure as simple closure with small circumferential incision was easier than colostomy which need exploration in most cases.