Raleigh Lean P Rojas and Manuel Rafael R Azares
University of the East Ramon Magsaysay Memorial Medical Center, Philippines
Posters & Accepted Abstracts: Surgery
Background & Aim: Diverting ileostomies (also termed as defunctionalizing ileostomies), have been used by surgeons to
mitigate anastomotic leak and to minimize pelvic sepsis after bowel surgery. Gastrointestinal continuity is restored after a
period of 6-12 weeks. The aim of this study was to evaluate the surgical outcomes and safety of early ileostomy closure, within
4 weeks of index surgery, in patients that have undergone colorectal surgery.
Method: Online research directory of Open Access Journals, CORE, Public Library of Science were searched from January
2000 up to June 2018 for studies that focused on comparing early (<4 weeks) and late (>4 weeks) closure of ileostomy following
bowel surgery. Meta-analysis was conducted using Review Manager 5.3.
Result: Eight studies met the inclusion criteria, yielding 1,126 patients (506 in EC and 620 in LC group). Meta-analysis showed
no significant statistical advantage of LC over EC of ileostomy in terms of over-all complication rate (OR of 2.32; 95% CI, 1.48-
3.63, p=0.0002), rate of anastomotic leakage (OR of 0.96; 95% CI, 0.55-1.66, p=0.54) and over-all mortality (OR of 2.00; 95%
CI, 0.18-22.29, p=0.57). EC had statistical advantage over LC in terms of occurrence of post-operative ileus/obstruction (OR of
0.36; 95% CI, 0.14-0.90, p=0.03). However, EC statistically was more likely to cause post-operative wound infection compared
to LC (OR of 2.32; 95% CI, 1.48-3.63, p=0.0002).
Conclusion: This meta-analysis suggests that early closure of an ileostomy is safe in carefully selected patients without
increasing overall postoperative complications.
E-mail: dalerojasmd@gmail.com
Journal of Surgery received 288 citations as per Google Scholar report
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