CLOSURE OF TRANSVERSE LOOP COLOSTOMY AND LOOP ILEOSTOMY

The aim of a defunctioning stoma is to protect patients from the conse quences of faecal leakage and pelvic sepsis, should it occur. A retros pective audit of 77 patients who had undergone closure of a loop stoma between 1988 and 1996 was performed. Sixty patients had either transv erse loop colostomy (52) or loop ileostomy (8) to defunction distal co lorectal/anal anastomoses or pathology, and 17 patients had a loop ile ostomy to defunction an ileoanal pouch. Those who had restorative proc tocolectomy experienced a much higher (24%) complication rate than the loop colostomy group (5%), despite similar perioperative care and sur gery performed by surgeons of equivalent seniority. The complication r ate of ileostomy closure in pouch patients is similar to other publish ed series. As a result of these findings, a selective approach to the use of loop ileostomy to protect pouches has been introduced. The abse nce of wound infections in our series would suggest that primary closu re of the stomal wound without drainage can be achieved.