The Feasibility of Early Closure of Defunctioning Loop Ileostomy after Low Anterior Resection for Rectal Cancer

Abstract

Background: The advantages of defuctioning loop ileostomy in some cases of rectal carcinoma is not questionable, but many patients experience serious stoma related complications and impaired quality of life. Early closure of the defunctioning ileostomy could mitigate these problem. Methods: This is a controlled randomized study done on 100 patients suffering of rectal cancer who had low anterior resection of the rectum and covering ileostomy at Menofiya University Hospital between April 2016 to august 2019. The patients were randomly divided (by closed envelope method) in two equal groups, Group A (Early group) and Group B (Late group). Results: As regards the pre-closure ileostomy complications: skin infection and maceration occurred in 4 pts. In early group and in 15 pts.in late group while dehydration and electrolyte imbalance occurred in 3 pts. In early group and in11 pts. In the late one, with both complications were significantly higher in late group (P value; 0.009 and 0,04 respectively). The health related quality of life was found to be higher in early group at 2 and 6 months than that in late group, but this did not yet reach significant difference, and at 12 month, the results were almost the same. Conclusion: Early ileostomy closure is safe, and not associated with higher complication rates in patients with an uncomplicated postoperative course and radiologically verified intact distal loopogram study.