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Chirurgie 9. Dezember 2014

Early protective ileostomy closure following stoma formation with a dual-sided absorbable adhesive barrier

Background: Usually, a temporary and diverting ileostomy is reversed not earlier than 8 weeks because of adhesions and edema along with vulnerability of the intestinal wall. We aimed to evaluate whether early closure of loop ileostomy during index admission using an antiadhesive bioabsorbable membrane is feasible and safe.

Methods: We included all patients undergoing ileostomy formation due to conventional or laparoscopy-assisted colorectal resections and stoma closure within 2 weeks using a dual-sided film between January 2011 and June 2012. Evaluation comprised patients’ demographic and disease characteristics, with objective to assess the rate and time interval of planned early stoma closure and length of hospital stay. Complications were divided related to stoma formation and closure. Follow-up data were collected by defined oncological aftercare.

Results: A total of 14 patients with a median age of 66 years were included. Median length of hospital stay was 27 days (range, 19–34 days), time between stoma formation and closure was 10 days (range, 8–14 days), and time of discharge was 8 days (range, 6–10 days) after stoma closure. Two complications related to stoma formation occurred in the form of one parastomal hernia and one wound infection. Complications related to stoma closure occured in five patients—one small bowel anastomotic leak in one patient and incisional hernias at stoma site in four patients.

Conclusion: Early ileostomy closure at index admission using an adhesive barrier appears to be a safe alternative to traditional closure.

G. Köhler, Doz. Dr. G. Spaun, Dr. R.-R. Luketina, Dr. S. A. Antoniou, Doz. Dr. O. O. Koch, Prof. Dr. K. Emmanuel, European Surgery 5/2014

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