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- W4242948521 abstract "Abstract Background Loop ileostomy (LI) formation is a common practice for patients undergoing low anterior resection or restorative ileo-anal pouch surgery. This can be performed using a stapled or hand-sewn technique, with or without resection. If hand-sewn, the closure can be one or two layers. Randomised controlled trials have not demonstrated one technique to be superior, and meta-analyses are limited by the heterogeneity of published studies. Our primary aim is to compare stapled ileostomy closure with single- and two-layer, hand-sewn closures.Methods This retrospective, single-centre cohort study included patients undergoing LI closure between January 1999 – April 2016. Patient demographics, anastomotic technique, operative time, and patient outcomes were collected.Results Our analysis included 244 patients (median age 67 years, 43.4% female). There were no significant differences in mean operative times (71.5, 73.1, and 88.5 minutes, for stapled, single-, and two-layer hand-sewn closures respectively, adjusted overall p=0.262), or morbidity (21.5% vs 20.4% vs 17.6%, adjusted overall p=0.934) between stapled or hand-sewn anastomoses, and no mortality. Once adjusting for age, sex, ASA, and consultant surgeon, the LOS was similar between stapled and single-layer closures (4.2 vs 5.5 days, p=0.105), but significantly different between stapled and two-layer closures (4.2 vs 8.3 days, p=0.026) (overall p=0.034). No evidence of differences in complications was found.Conclusions Stapled and single-layered hand-sewn closures are similar in length of procedure, LOS, and complication rates. A two-layer, hand-sewn technique is associated with a significant increase in stay compared to a stapled ileostomy closure." @default.
- W4242948521 created "2022-05-12" @default.
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- W4242948521 date "2019-08-28" @default.
- W4242948521 modified "2023-10-16" @default.
- W4242948521 title "Loop ileostomy closure: a retrospective comparison of three techniques" @default.
- W4242948521 doi "https://doi.org/10.21203/rs.2.13283/v1" @default.
- W4242948521 hasPublicationYear "2019" @default.
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