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Surgery Today
Published in: Surgery Today 3/2019

01-03-2019 | Original Article

Purse-string approximation vs. primary closure with a drain for stoma reversal surgery: results of a randomized clinical trial

Authors: Kunihiko Amamo, Hideyuki Ishida, Kensuke Kumamoto, Norimichi Okada, Satoshi Hatano, Noriyasu Chika, Yusuke Tajima, Tomonori Ohsawa, Masaru Yokoyama, Keiichiro Ishibashi, Erito Mochiki

Published in: Surgery Today | Issue 3/2019

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Abstract

Purpose

Stoma reversal carries a risk of surgical site infection (SSI). Purse-string approximation (PSA) has been reported as an attractive alternative to conventional primary wound closure for stoma reversal, but its efficacy is still under debate.

Methods

Patients undergoing elective stoma reversal were randomized to undergo PSA or primary closure with a drain (PCD). All patients received preoperative bowel cleansing and antimicrobial prophylaxis. The primary endpoint was the incidence of wound healing at the stoma site 30 days after surgery. The secondary endpoint was the 30-day SSI rate after surgery.

Results

A total of 159 patients (PCD group, n = 79; PSA group, n = 80) were eligible for this study. The incidence of wound healing at the stoma site was 92.4% in the PCD group and 62.5% in the PSA group [difference (95% confidence interval − 29.9% (− 42.9 to − 16.9%)]. The 30-day SSI rate at the stoma site, as the secondary endpoint, was 8.9% in the PCD group and 5.0% in the PSA group (P = 0.35).

Conclusions

These results suggest that PCD may remain the standard procedure for stoma reversal surgery.
Appendix
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Metadata
Title
Purse-string approximation vs. primary closure with a drain for stoma reversal surgery: results of a randomized clinical trial
Authors
Kunihiko Amamo
Hideyuki Ishida
Kensuke Kumamoto
Norimichi Okada
Satoshi Hatano
Noriyasu Chika
Yusuke Tajima
Tomonori Ohsawa
Masaru Yokoyama
Keiichiro Ishibashi
Erito Mochiki
Publication date
01-03-2019
Publisher
Springer Singapore
Published in
Surgery Today / Issue 3/2019
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-018-1729-5

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