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Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

2009, Number 6

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Rev Invest Clin 2009; 61 (6)

Open vs. laparoscopic loop ileostomy clousure after colorectal surgery: retrospective analysis

Rodríguez-Zentner HA, Castañeda-Argáiz R, Vergara-Fernández O, Moreno-Berber JM, Tapia H, Velázquez-Fernández D, González QH

Language: Spanish
References: 16
Page: 461-465
PDF size: 51.56 Kb.


ABSTRACT

Introduction. A protective loop ileostomy for a distal anastomosis of the rectum or anus, decreases the risk of sepsis secondary to anastomotic leak or dehiscence. This study examines whether the surgical technique employed in the construction of the anastomosis (open vs. laparoscopic) alters the subsequent closure of ileostomy. Objective. The goal of this study is to determine whether at the time of a protective ileostomy closure, the fact of doing an initial laparoscopic surgery has advantages over those who underwent open surgery. Material and methods. This is a comparative and retrospective analysis of the results of an ileostomy closure with prior open surgery (ICPOS) vs those performed with a prior laparoscopic surgery (ICPLS). Demographic and surgical results were analyzed. Fisher’s test and Chi square tests were used. A statistically significant results was defined as p ‹ 0.05. Results. A total of 71 patients were included: 42 (59.2%) ICPOS and 29 (40.8%) ICPLS. Surgical time and hospital stay were less in the ICPLS group when compared with the ICPOS group. 79 vs. 133 min (p = 0.0001) and 3 vs. 5 days (p = 0.0001). Four patients (66.7%) from the ICPOS group developed ileum, whereas only 2 (33.3% from the ICPLS presented it (p = 0.04). Six patients had surgical wound infection, 5 (83.3%) of them represented the ICPOS group and only 1 (16.7%) represented the ICPLS group (p = 0.01). Four patients (5.6%) had anastomotic dehiscence, all of them were from the ICPOS group (p = 0.0037). On the ICPOS group 6 patients were reinterveined after the ileostomy closure, whereas none from the ICPLS required it (p = 0.01). Conclusions. An ICPLS seems to have advantages over a ICPOS when analyzing surgical time, hospital stay and surgical ileum development, a lesser infection rate and a lesser re intervention rate at last.


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