A PROSPECTIVE STUDY FOR ASSESSING THE OUTCOMES AFTER EARLY AND DELAYED ILEOSTOMY REVERSAL IN A TERTIARY CARE CENTRE
Md. Hasanuzzaman, Asis Kumar Saha*, Prasenjit Das, Saran Hembram, Arijit Banik, Krishnendu Mondal
Background: - Temporary ileostomy or diverting ileostomy is done frequently to prevent the consequence of primary anastomotic leakage, to control the abdominal sepsis or as a part of damage control surgery. On the other hand ileostomy is also associated with certain complications like peristomal excoriation, fluid electrolyte imbalance, dehydration, renal compromisation and social separation. So our main aim of the study is to compare the outcomes between early and delayed ileostomy reversal according to feasibility, cost of therapy, hospital stay, morbidity, mortality and health related quality of lifestyle for the patients with temporary ileostomy. Methods: - 50 patients who underwent temporary ileostomy in our tertiary care centre after meeting the inclusion and exclusion criteria were included in the study. They were divided into two groups with 20 patients in early reversal arm and 30 patients in delayed reversal arm. Both groups were compared on the basis of various parameters. Results: - There were statistically significant advantage of early reversal of ileostomy group over delayed reversal group in terms of stoma related complications, less intraoperative adhesion, post operative morbidities and length of hospital stay. Whereas complications like anastomotic leak, wound dehiscence, faecal fistula and incidence of post operative incisional hernia formations were statistically not significant in both groups. Although post operative wound infection is more common in early reversal group. No mortality was recorded in both groups. Conclusions: - Early reversal of temporary ileostomy is feasible immediately after recovery from primary emergency conditions without any increased risk of different perioperative complications.
Keywords: Ileostomy, Ileostomy reversal, Early reversal.
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