| Abstract [eng] |
Aim and objectives: This study aimed to assess whether closing the loop ileostomy earlier helps reduce the rate of postoperative complications and enhances the patient's quality of life, as measured using Low Anterior Resection Syndrome (LARS) and Wexner questionnaires. The objectives were to determine rate and severity of postoperative complications according to the Clavien-Dindo classification, to assess changes in bowel function and to analyze the causes of delayed closure of the ileostomy. As there is a lack of data on the timing of ileostomy closure and its impact on patients in Lithuania, the results of this study may help to improve patient care. Methods: All patients were included in the study who underwent low anterior resection and ileostomy and later had ileostomy reversal between January 2019 to May 2023. 180 patients were assessed and contacted. Of them 107 (59 %) answered the LARS and Wexner questionnaires. Of 107 patients, 51 were men (47.7 %) and 56 were women (52.3 %). The time to ileostomy closure ranged between 0.5 and 28 months, with a median of 5. Patients were divided into two groups: early closure (<3 months) compared to late closure (>3 months). There were 46 (43 %) patients in the early closure group and 61 (57 %) – in late closure. This study evaluated patient demographics, clinical and operative data, and postoperative complication rates (graded according to severity using the Clavien-Dindo scale). Results: In the early and late closure groups, postoperative ileostomy-related complications were observed in 4.3 % vs. 14.8 % (p=0.0793) of patients and postoperative ileus occurred in 6.5 % vs. 4.9 % (p=0.7211) of patients, respectively. Median LARS score was 25 vs. 20 (p=0.9899) and Wexner's 2.5 vs. 2 (p=0.8236), respectively. The previously discussed indicators (postoperative ileostomy-related complication, postoperative ileus rate, LARS and Wexner scores) were not statistically significantly different. Conclusion: In this small retrospective study, early ileostomy closure had no impact on rates of postoperative complications related to ileostomy closure or on bowel function outcomes, compared to late closure. |
