Özcan P, Düzgün Ö. Comparison of complication rates after early and late closure of loop ileostomies: A retrospective cohort study. World J Gastrointest Surg 2025; 17(8): 109432 [DOI: 10.4240/wjgs.v17.i8.109432]
Corresponding Author of This Article
Pırıltı Özcan, MD, Researcher, Department of General Surgery, Yerköy Sehit Korgeneral Osman Erbas State Hospital, Bekir Bozdag Road, Gazi Muhtarpasa Street no:112, Yozgat 66900, Türkiye. piriltiozcan@gmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Aug 27, 2025; 17(8): 109432 Published online Aug 27, 2025. doi: 10.4240/wjgs.v17.i8.109432
Comparison of complication rates after early and late closure of loop ileostomies: A retrospective cohort study
Pırıltı Özcan, Özgül Düzgün
Pırıltı Özcan, Department of General Surgery, Yerköy Sehit Korgeneral Osman Erbas State Hospital, Yozgat 66900, Türkiye
Özgül Düzgün, Department of Surgical Oncology, University of Health Sciences, İstanbul Ümraniye Training and Research Hospital, Istanbul 34766, Türkiye
Co-corresponding authors: Pırıltı Özcan and Özgül Düzgün.
Author contributions: Özcan P collected the patients’ clinical data, analyzed the data, and wrote the manuscript; Düzgün Ö contributed to the supervision of the project and to preparation of the original draft.
Institutional review board statement: Ethical approval for the study was obtained from the Ethics Committee of the University of Health Sciences, Ümraniye Training and Research Hospital (approval No. 2022/366).
Informed consent statement: Informed waiver consent was obtained from the patients for the study.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
STROBE statement: The authors have read the STROBE Statement—a checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-a checklist of items.
Data sharing statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Pırıltı Özcan, MD, Researcher, Department of General Surgery, Yerköy Sehit Korgeneral Osman Erbas State Hospital, Bekir Bozdag Road, Gazi Muhtarpasa Street no:112, Yozgat 66900, Türkiye. piriltiozcan@gmail.com
Received: May 12, 2025 Revised: June 3, 2025 Accepted: July 10, 2025 Published online: August 27, 2025 Processing time: 107 Days and 3.6 Hours
Abstract
BACKGROUND
In the treatment of rectal cancer, a temporary loop ileostomy (TLI) is created after low anterior resection to protect bowel function in the postoperative period. Dehydration and kidney failure are significant potential complications in loop ileostomies. Compared to late closure (3-6 months), early closure (10-14 days) of the TLI may facilitate faster patient recovery and shorter hospital stays.
AIM
To compare early and late closure of TLIs and demonstrate that early stoma closure can be performed without increasing morbidity.
METHODS
This study included patients who underwent TLI for rectal cancer, with data collected prospectively between June 2016 and October 2024 and analyzed retrospectively. Patients whose stomas were closed in the late period (3-6 months) between June 2016 and October 2022 (group A) were compared with those who underwent early closure (10-14 days) between October 2022 and 2024 (group B), with the primary outcome being complication rate and the secondary outcome being quality of life.
RESULTS
A total of 270 TLIs were created (70.9%). Of these, 120 (44.4%) were closed in the late period (group A), and 150 (55.6%) were closed in the early period (group B). There was no statistically significant difference between group A and group B in terms of demographic and clinicopathological characteristics (P > 0.05). Perioperative (anesthesia management, operative time, blood loss, surgical technique) and postoperative findings (anastomotic leak, infection) were similar between the two groups and were not statistically significant (P > 0.05). There were no statistically significant differences in complication rates as the primary outcome between the two groups. Quality of life as a secondary outcome was significantly higher in the early closure group (P < 0.05).
CONCLUSION
No statistically significant difference was found between early and late loop ileostomy closure in terms of perioperative and postoperative morbidity. Early closure accelerated patients’ psychological and social recovery.
Core Tip: This retrospective study compares early (group A: 10-14 days) and late (group B: 3-6 months) closure of diverting loop ileostomies (DLI) in patients who underwent surgery for rectal cancer, aiming to demonstrate the feasibility of early stoma closure without increasing morbidity. The results showed no significant differences in morbidity or mortality between the two groups. However, early DLI closure was associated with faster psychological and social recovery in patients.
