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ORIGINAL ARTICLE   

Chirurgia 2021 June;34(3):110-3

DOI: 10.23736/S0394-9508.20.05135-9

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Classification of the complications of the loop-ileostomy closure procedure according to the Clavien-Dindo grading system

Okan M. AKTURK , Mikail CAKIR

Department of Surgery, University of Health Sciences Istanbul Haseki Training and Research Hospital, Istanbul, Turkey



BACKGROUND: Loop ileostomy is a procedure aimed to reduce anastomotic leakage in colorectal surgery. The primary outcome of the study was complications associated with the ostomy reversal according to the Clavien-Dindo classification. The secondary outcome was the investigation of the risk factors that are associated with the stoma reversal complications.
METHODS: The patients who underwent ileostomy reversal were reviewed. The complications were graded according to the Clavien-Dindo classification system. The demographics and preoperative laboratory parameters were evaluated about the prediction of complications.
RESULTS: The overall complication rate was 25%. Age, sex, the type of the anastomosis, preoperative hemoglobin, albumin and the inflammatory parameter (red cell distribution width) proved to be insignificant about the prediction of complications (P=0.787, P=0.180, P=1, P=0.598, P=0.286, P=0.835). The power of the sample of 44 patients at α=0.05 is 0.5. The most common complication was low grade (1-2) wound infections.
CONCLUSIONS: Loop ileostomy reversal is a procedure with major complications less than 10%. Stapler anastomosis was associated with leakage compared to the hand-sewn anastomosis. The two methods did not differ in overall complication rates. When assessing the preoperative patients, factors like anemia, mild hypoalbuminemia and inflammatory parameters cannot predict complications.


KEY WORDS: Ileostomy; Complications; Ostomy

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