Loop ileostomy: Technical aspects and complications

Objective: To study the incidence of complications of construction and clos ure of loop ileostomies and the final outcome for the patients. Design: Retrospective study. Setting: University hospital, Norway. Subjects: 100 patients with 103 loop ileostomies, operated on between 1980 and 1990. Main outcome measures: Number of complications after ileostomy construction and closure. Results: 7 required re-operation after construction of the loop ileostomy a nd 11 after its closure. The most common cause was small intestinal obstruc tion (4 after construction and 6 after closure). 2 developed stomal necrosi s. The mean duration of hospital stay was 13 and 10 days for primary and se condary loop ileostomy, respectively, and the mean time before closure was 31 weeks. After closure another 6 developed leaks from the ileal anastomosi s that required further operation. Patients with secondary loop ileostomies had their stomas significantly longer than those with primary loop ileosto mies (21 compared with 43 weeks, p = 0.00005). Conclusion: Despite the number of complications, we think that faecal diver sion is still justified in complex pelvic surgery and we should try to redu ce the complication rate further.