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Erschienen in:
01.01.2012 | Original Article
Postoperative complications after closure of a diverting ileostoma—differences according to closure technique
Erschienen in: International Journal of Colorectal Disease | Ausgabe 1/2012
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Purpose
The aim of this study was to compare three methods for closure of a diverting ileostoma according to development of postoperative small-bowel obstruction (SBO) and anastomotic leakage (AL).
Methods
Complications arising within 30 days after closure of a defunctioning loop ileostomy in 351 patients during the period 1999–2006 were studied retrospectively by evaluation of case records. The techniques employed were: hand-sewn anastomosis without bowel resection, hand-sewn anastomosis with bowel resection and stapled anastomosis.
Results
Of the 351 patients, 149 had a hand-sewn anastomosis without bowel resection (HS), 70 had a hand-sewn anastomosis with bowel resection (HSR) and 132 patients had a stapled anastomosis (S). The total number of SBOs was 44 patients (12.5%). In the two hand-sewn groups, 15.5% (34 patients) suffered postoperative SBO compared to 7.6% (10 patients) in the stapled group (p = 0.029). No difference in AL could be found between the groups, where the overall frequency was 2.8% (10 patients). Median hospital stay was 6 days in the HS group, 5 days in the HSR group and 4 days in the S group (p = 0.001).
Conclusion
In the present study, stapled anastomosis was associated with a lower frequency of postoperative SBO and a shorter hospital stay compared to sutured anastomosis (either with or without a short small-bowel resection) after closure of a diverting ileostoma.