Early takedown of a defunctioning ileostomy, is there a downside? – a prospective analysis from Rural Bengal

Shouptik Basu; Dhrubajyoti Maulik; Jaganmoy Maji

doi:10.18203/2349-2902.isj20205899

Authors

Shouptik Basu Department of General Surgery, Bankura Sammilani Medical College and Hospital, Bankura, West Bengal, India
Dhrubajyoti Maulik Department of General Surgery, Bankura Sammilani Medical College and Hospital, Bankura, West Bengal, India
Jaganmoy Maji Department of General Surgery, Bankura Sammilani Medical College and Hospital, Bankura, West Bengal, India

DOI:

https://doi.org/10.18203/2349-2902.isj20205899

Keywords:

Ileostomy, Defunctioning, Loop, Stoma, Reversal, Takedown

Abstract

Background: Since the pilot study in 2002, many studies have evaluated the feasibility of an Early Ileostomy takedown by 2 weeks, thus decreasing the stoma related morbidity. However, in a developing country like India, this paradigm shift is still debatable. Our study from a tertiary teaching rural hospital in Bengal evaluates the feasibility of Early takedown by 2 weeks and compares it to a more accepted concept of Ileostomy takedown by 8-10 weeks.

Methods: This prospective longitudinal comparative study conducted from February 2018 to July 2019, in our institute. Sample size was calculated to be 30 in each group. The early closure went a takedown at 2 weeks and the delayed closure underwent a takedown by 8-10 weeks. Data was analysed with Fischer’s exact or Chi square test, student’s t test. A p value of 0.05 was significant.

Results: Our set of rural patients, had more stoma related complications due to lack of stoma care (13.33% vs 3.33%, EC vs DC). Intraoperative adhesions (26 vs 12, p=0.0004) significantly increased operative time (126.1667±27.5895 vs 86.0000±34.2506, EC vs DC, p<0.001), leading to post-operative complications hence, the Length of hospital stay was more in the early subset (17.9667±6.9851 vs 11.2000±4.0548, EC vs DC, p<0.001).

Conclusions: An early takedown of a defunctioning ileostomy, may be a technically difficult procedure to perform, has more post-operative complications and is discouraged, in our opinion.

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Author Biography

Shouptik Basu, Department of General Surgery, Bankura Sammilani Medical College and Hospital, Bankura, West Bengal, India

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