OBJECTIVE: To compare the outcome after conventional sutured loop ileostomy closure with stapled ileostomy closure. SUMMARY BACKGROUND DATA: A defunctioning loop ileostomy is now widely used in colorectal surgery. Subsequent closure may be associated with early complications, particularly bowel obstruction. The results of a preliminary nonrandomized study suggested that there was no significant difference in the rate of complications between sutured and stapled closure of loop ileostomy. METHODS:One hundred forty-one consecutive patients who underwent loop ileostomy between 1993 and 1998 were randomized before surgery to eithersutured or stapled loop ileostomy closure. Seventy-one patients had stapled closure and 70 had sutured closure. RESULTS: Both groups were comparable in terms of age, sex, original operation, duration after original operation, and level of operating surgeon. Postoperative bowel obstruction occurred in 10/70 (14%) patients after sutured closure compared with 2/71 (3%) patients after stapled closure. Subgroup analysis of ileostomy closure in patients having an ileal pouch showed no significant difference in bowel obstruction between stapled and sutured closure (2/30 vs. 7/29). The incidence of other complications, readmissions, and reoperations did not differ between the two groups. The stapled closure was only 4 minutes quicker than sutured closure. The mean total hospital stay tended to be shorter after the stapled closure than the sutured closure, but this did not reach statistical significance. CONCLUSIONS:Bowel obstruction occurred less frequently after stapled closure, but the mean hospital stay and readmission and reoperation rate did not significantly differ between the two groups.
RCT Entities:
OBJECTIVE: To compare the outcome after conventional sutured loop ileostomy closure with stapled ileostomy closure. SUMMARY BACKGROUND DATA: A defunctioning loop ileostomy is now widely used in colorectal surgery. Subsequent closure may be associated with early complications, particularly bowel obstruction. The results of a preliminary nonrandomized study suggested that there was no significant difference in the rate of complications between sutured and stapled closure of loop ileostomy. METHODS: One hundred forty-one consecutive patients who underwent loop ileostomy between 1993 and 1998 were randomized before surgery to either sutured or stapled loop ileostomy closure. Seventy-one patients had stapled closure and 70 had sutured closure. RESULTS: Both groups were comparable in terms of age, sex, original operation, duration after original operation, and level of operating surgeon. Postoperative bowel obstruction occurred in 10/70 (14%) patients after sutured closure compared with 2/71 (3%) patients after stapled closure. Subgroup analysis of ileostomy closure in patients having an ileal pouch showed no significant difference in bowel obstruction between stapled and sutured closure (2/30 vs. 7/29). The incidence of other complications, readmissions, and reoperations did not differ between the two groups. The stapled closure was only 4 minutes quicker than sutured closure. The mean total hospital stay tended to be shorter after the stapled closure than the sutured closure, but this did not reach statistical significance. CONCLUSIONS:Bowel obstruction occurred less frequently after stapled closure, but the mean hospital stay and readmission and reoperation rate did not significantly differ between the two groups.
Authors: S D Wexner; D A Taranow; O B Johansen; F Itzkowitz; N Daniel; J J Nogueras; D G Jagelman Journal: Dis Colon Rectum Date: 1993-04 Impact factor: 4.585
Authors: Leith Williams; Matthew J Armstrong; Matthew Armstrong; Paul Finan; Peter Sagar; Dermot Burke Journal: Gut Date: 2007-01-17 Impact factor: 23.059