Comparing methods of ileostomy closure constructed in colorectal surgery

Stoma construction is a life-saver method for emergent and elective operations in colorectal surgery. However, they are associated with high rates of morbidity and mortality. The aim of this study is to compare the operative findings, early postoperative complications and costs of stapled and handsewn closures in loop ileostomies, that are constructed for fecal diversion in emergent and elective colorectal surgery. The data of 68 patients requiring loop ileostomies during colorectal surgery between January 2007 and December 2011 at Akdeniz University School of Medicine, General Surgery Clinic were retrospectively evaluated. SPSS (version 20) was used for data analysis. The study group consisted of 44 men and 24 women with a mean age of 55,5 years. The ileostomy closures were performed with handsewn method in 36 patients (Group 1) and stapled method in 32 patients (Group 2). The mean operation time was 75,4 minutes in group 1 and 46,7 minutes in group 2 (p=0,00). The mean time elapsed until the first flatus or defecation was 2,55 days in the handsewn group and 2,46 days in the stapled group (p=0,759). The mean hospital stay after stoma closure was 7,08 days in group 1 and 5,5 days in the other group (p= 0,210). Early postoperative complications were wound infection (8,8%), small bowel obstruction (6,06%) and anastomotic leakage (2,9%). There were no difference statistically detected in early postoperative complications between the groups. Total costs were lower in the stapled group (p=0,018). Morbidity and mortality rates of stoma construction and it's closure are still considerable. Less anastomotic leakage rates, lower costs and shorter operative times in the stapled group will make this method preferable. Key words: Loop ileostomy; Closure technique; Handsewn anastomosis; Stapled technique; Surgical outcomes.