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01-09-2019 | Original Article

Morbidity associated with closure of ileostomy after a three-stage ileal pouch-anal anastomosis

Authors: Matteo Rottoli, Benedetta Casadei, Carlo Vallicelli, Giulia Vitali, Federico Ghignone, Marica Melina, Marta Tanzanu, Gilberto Poggioli

Published in: Updates in Surgery | Issue 3/2019

Abstract

The aim of the study was to compare the perioperative outcomes of patients undergoing ileostomy closure after a three-stage ileal pouch-anal anastomosis to a control group of patients who had elective colorectal resections and stoma, and to analyse the differences based on the technique of closure. The cases were retrospectively compared for demographic characteristics and postoperative outcomes. Chi-square, Fisher’s exact and Wilcoxon rank sum tests were used as appropriate. Between 2011 and 2016, 338 patients having their stoma reversed after three-stage IPAA were compared to 158 patients in the control group. A younger age (43.2 vs 60.6 years, p < 0.0001), a lower body mass index (22 vs 24.4 kg/m², p < 0.0001), a higher rate of hand-sewn anastomosis (84.3 vs 15.7%, p < 0.0001), a lower rate of intraoperative complications (0 vs 1.2%, p = 0.038), a shorter operative time (91.5 vs 99.4 min, p = 0.0046) and length of hospital stay (6.6 vs 7.6 days, p = 0.045) were seen in the IPAA group. The 30-day rate of wound infection, anastomotic leak (0.6 vs 0.6%), small bowel obstruction (SBO, 8 vs 11.4%) and reoperation (1.8 vs 1.3%) was similar. Among IPAA patients, the hand-sewn anastomosis was correlated with a higher chance of developing SBO (9.1 vs 1.9%, p = 0.03). Closure of ileostomy after three-stage IPAA is associated with low rate of serious complications, despite the higher number of previous abdominal surgeries. This supports the construction of routine ileostomy during IPAA to reduce the risk of pelvic sepsis.

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Title: Morbidity associated with closure of ileostomy after a three-stage ileal pouch-anal anastomosis
Authors: Matteo Rottoli
Benedetta Casadei
Carlo Vallicelli
Giulia Vitali
Federico Ghignone
Marica Melina
Marta Tanzanu
Gilberto Poggioli
Publication date: 01-09-2019
Publisher: Springer International Publishing
Published in: Updates in Surgery / Issue 3/2019
Print ISSN: 2038-131X
Electronic ISSN: 2038-3312
DOI: https://doi.org/10.1007/s13304-018-0594-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Morbidity associated with closure of ileostomy after a three-stage ileal pouch-anal anastomosis

Abstract

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Springer Medicine

Abstract

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