Results and indications of loop ileostomy in colorectal surgery.

Loop ileostomy (LI) ensures fecal diversion to protect an anastomosis or an atomic colorectal or ano-perineal damage. The aim of this retrospective stu dy was to evaluate loop ileostomy morbidity in emergency and planned colore ctal surgery. Patients and methods: From 1991 to 1996, 145 loop ileostomies were performed in 139 patients, 77 men and 62 women with a mean age of 48. 7 years (15-82). The etiology was a rectal tumor (cancer or large villous t umor n = 47), inflammatory bowel disease (n = 47, ulcerative colitis = 37 a nd Crohn's disease = 10) Familial Adenomatous Polyposis (n = 13) and other diseases (n = 32). 80% LI (n = 116)protected ileo-anal anastomoses (n = 46) cole-anal anastomoses (n = 45, 26 with colonic pouch), ileo-rectal anastom oses (n = 11) and other anastomoses (n = 15). 20% LI (n = 29) defunctioned ano-perineal lesions (n = 8), anastomosis leak (n = 4) or distal bowel with out intestinal resection (n = 17). Results: 7 deaths were not stoma-related . 91% LI were closed after a mean diversion time of 3.6 months. LI closure was performed by a parastomal (n = 128) or laparotomy procedure (n:= 4). Mo rbidity during LI diversion was observed in 24 patients (16.5%) 12 of whom (8.3%) were operated for small bowel obstruction (n = 6; 4.2%) stoma revisi on (n = 5; 3.5%) and prolapse (n = 1; 0.7%). 2 patients had peristomal skin excoriations, and 5 patients required readmission for dehydratation due to high LI output. Morbidity after LI closure was observed in 12 patients (8. 6%) 5 of whom were operated for anastomotic leak (n = 4) or small bowel obs truction (n = 1). Low morbidity and defunctioning efficiency confirm the in dications for LI. LI is our first-line stoma in planned or emergency colore ctal surgery.