[Morbidity and mortality associated with diverting ileostomy closures in rectal cancer surgery]

Abstract

Introduction: Derivative ileostomies are frequently performed to protect low anastomosis. The closure of the ileostomy has shown, under some circumstances, high associated mortality/morbidity rates. This study attempts to quantify the morbidity and mortality associated with ileostomy closure in rectal neoplasm patients and to determine if the length of time between the procedure of construction and closure increases the morbidity/mortality.

Material and method: A retrospective study was performed, using the database of the colo-rectal surgical group in the department of general surgery. The subjects were the 62 patients treated between January 1, 2000 and December 31, 2006 who received both a low anterior resection to treat rectal neoplasm and a subsequent ileostomy closure.

Results: The mean patient age was 65 years (38-83) and consisted of 19 women (30.7%) and 43 men (69.3%). The mean time between the construction and closure was 10.48 months (2-56) and the mean hospital stay was 7.8 days (3-32). The overall morbidity/mortality rate was 33.8% and 6.4%. The most frequent surgical complications were postoperative intestinal occlusion (16.9%) and wound infection (11.2%).

Conclusions: The study showed high morbidity/mortality rate for the closure of temporary ileostomy. Patients who received the closure more than 11.65 months after the low anterior resection had significantly higher morbidity/mortality rates.