Defunctioning loop ileostomy: A prospective audit

Background: Defunctioning loop ileostomies are uncommonly used forms of fec al diversion. The aim of this study was to determine the morbidity associat ed with both construction and reversal. of loop ileostomies. Study Design: An analysis was performed of all patients who underwent loop ileostomy construction or reversal between 1990 and 1997, with data being c ollected prospectively. Results: One-hundred-two patients, (43 male, 59 female) with a mean age of 38 years (range 13 to 81 years) had loop ileostomies constructed. Indicatio ns for ileostomy construction included inflammatory bowel disease (76 patie nts), ultralow anterior resection for carcinoma (16 patients), or miscellan eous reasons (10 patients). Nine patients (9%) had complications arising fr om ileostomy construction including 4 parastomal infections, 3 high output ileostomies, 1 small-bowel obstruction, and 1 ileostomy stenosis in the ear ly postoperative period. Only the stricture required surgical intervention. AU other complications improved with conservative management. Mean time to ileostomy reversal was 120 days. Three patients (4%) had complications ass ociated with reversal. AU of these complications required surgical interven tion, 2 for small bowel obstruction, and I for small bowel perforation. Cur rently 84 patients have had their ileostomy reversed, and 12 patients have had their loop ileostomy converted to a permanent stoma for reasons not rel ated to the loop ileostomy itself. Conclusions: Defunctioning loop ileostomy is associated with low morbidity. We recommend a defunctioning ileostomy as the procedure of choice for temp orary fecal diversion. (J Am Coil Surg 1999;188:6-9. (C) 1999 by the Americ an College of Surgeons).