Impact of defunctioning loop ileostomy on outcome after restorative proctocolectomy for XXXX .

@entity1 @entity834 @entity341 @entity31 @entity254 @entity530 @entity1960 @entity230
PURPOSE: This study analyzes the impact of a temporary loop ileostomy on postoperative outcome after restorative proctocolectomy for @entity31 in terms of complications and reoperations including ileostomy closure. METHODS: The records of 122 consecutive @entity1 undergoing restorative proctocolectomy for @entity31 during a 12-year period were reviewed. In 89 @entity1 , a defunctioning ileostomy was created, while 33 @entity1 had no ileostomy. Statistics were done with Chi-square test and Mann-Whitney U test, p   <   0.05 considered significant. RESULTS: Both study groups were comparable concerning age, @entity1960 activity, previous diseases, previous surgery, use of @entity230 , and immunosuppressives. Pouch-related septic complications ( @entity834 dehiscence, pouch leakage, @entity530 ) were significantly lower in the ileostomy group (5.6% vs. 18.2%, p   =   0.031), resulting in a lower rate of @entity341 following restorative proctocolectomy (4.5% vs. 30.3%, p   <   0.001). Including all complications associated with scheduled closure of ileostomy, the cumulative frequency of @entity341 was significantly lower in the ileostomy group (13.5% vs. 30.3%, p   =   0.032). The cumulative duration of hospitalization, including all hospital stays for complications or closure of the ileostomy, was significantly longer in the ileostomy group [median 22  days (11-92) vs. 14  days (9-109), p   <   0.001]. During long-term follow-up, a stricture at the pouch-anal @entity254 was more common in the ileostomy group (24.7% vs. 6.1%, p   =   0.021), whereas only one stricture necessitated surgical therapy. CONCLUSIONS: Creation of a defunctioning loop ileostomy reduces pouch-related septic complications and the frequency of emergency second laparotomies after restorative proctocolectomy for @entity31 .
