Outcome of Delayed Stoma Closure in Patients Presenting to Tertiary Care Hospital

Authors

  • Aamir Fareed Lady Reading Hospital, Peshawar, KP, Pakistan.
  • Ahmad Faraz Lady Reading Hospital, Peshawar, KP, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v3i6.2021

Keywords:

Ileostomy Closure, Delayed Reversal, Stoma Complications, Skin Excoriation, Retraction, Prolapse, Diabetes, Hypertension

Abstract

Background: A late closure of ileostomies may have various post-operative complications, more in resource-limited settings where follow-up as well as preventive methods often stay suboptimal. Though early reversal is ideal, delays happen quite often, and assessment of the risk for a poor outcome is important in surgical decision-making and counseling of the patient. Objective: To determine the outcome of delayed stoma closure in patients presenting to tertiary care hospital. Study Design: Descriptive cross-sectional study. Duration and Place of Study: Conducted from October 2024 to March 2025 in the Department of General Surgery LRH Peshawar. Methodology: A total of 128 patients aged 18–65 years, undergoing ileostomy reversal beyond 14 days of initial surgery, were enrolled through consecutive non-probability sampling. Exclusion criteria included abdominal tuberculosis, inflammatory bowel disease, bleeding disorders, or psychiatric illness. Data on demographics, comorbidities, and post-operative outcomes were collected. Complications were evaluated over a 30-day post-reversal period. Results: Skin excoriation occurred in 27.3%, retraction in 6.3%, and prolapse in 2.3% of patients. Diabetes and hypertension were significantly associated with higher rates of excoriation (p<0.001 and p=0.052, respectively), while hypertension also showed a strong association with both retraction (p<0.001) and prolapse (p=0.015). Conclusion: Delayed ileostomy closure is associated with notable rates of skin-related complications, with diabetes and hypertension emerging as key risk factors.

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References

1. Ma, H., Li, X., Yang, H., Qiu, Y., & Xiao, W. (2022). The pathology and physiology of ileostomy. Frontiers in Nutrition, 9.

https://doi.org/10.3389/fnut.2022.842198

2. Parini, D., Bondurri, A., Ferrara, F., Rizzo, G., Pata, F., Veltri, M., Forni, C., Coccolini, F., Biffl, W. L., Sartelli, M., Kluger, Y., Ansaloni, L., Moore, E., Catena, F., & Danelli, P. (2023). Surgical management of ostomy complications: A MISSTO–WSES mapping review. World Journal of Emergency Surgery, 18(1).

https://doi.org/10.1186/s13017-023-00516-5

3. ALBULESCU, E. L., BRATILOVEANU, T., SANDULESCU, S., RAMBOIU, S., NEMES, R., SURLIN, V., & CHIUTU, L. (2024). Role of a Stoma Nurse in the Management of the Specific Stoma-Related Complications. Current Health Sciences Journal, 50(1), 5–11.

https://doi.org/10.12865/CHSJ.50.01.01

4. Schreiber, M. E., Schneider, M. A., Murray, F. R., Turina, M., & Gubler, C. (2023). Routine endoscopy prior to surgical ostomy closure: An obsolete concept. Digestive Diseases and Sciences, 68(11), 4130-4139.

https://doi.org/10.1007/s10620-023-08088-9

5. Michońska, I., Polak-Szczybyło, E., Sokal, A., Jarmakiewicz-Czaja, S., Stępień, A. E., & Dereń, K. (2023). Nutritional issues faced by patients with intestinal stoma: A narrative review. Journal of Clinical Medicine, 12(2), 510.

https://doi.org/10.3390/jcm12020510

6. O’Sullivan, N. J., Temperley, H. C., Nugent, T. S., Low, E. Z., Kavanagh, D. O., Larkin, J. O., Mehigan, B. J., McCormick, P. H., & Kelly, M. E. (2022). Early vs. standard reversal ileostomy: A systematic review and meta-analysis. Techniques in Coloproctology, 26(11), 851-862.

https://doi.org/10.1007/s10151-022-02629-6

7. MacDonald, S., Gallagher, A., McNicholl, L., McElroy, L., Hughes, R., Quasim, T., & Moug, S. (2025). Stoma reversal after emergency stoma formation—the importance of timing: A multi-centre retrospective cohort study. World Journal of Emergency Surgery, 20(1).

https://doi.org/10.1186/s13017-025-00598-3

8. Tsujinaka, S., Suzuki, H., Miura, T., Sato, Y., Murata, H., Endo, Y., Hoshi, K., Sato, Y., & Shibata, C. (2023). Diagnosis, treatment, and prevention of ileostomy complications: An updated review. Cureus.

https://doi.org/10.7759/cureus.34289

9. Dawes, A. J., & Gahagan, J. V. (2023). Stoma complications. Clinics in Colon and Rectal Surgery, 37(06), 387-397.

https://doi.org/10.1055/s-0043-1777453

10. Maeda, K. (2022). Prolapse of intestinal stoma. Annals of Coloproctology, 38(5), 335-342.

https://doi.org/10.3393/ac.2022.00465.0066

11. Irani, J. L., Hedrick, T. L., Miller, T. E., Lee, L., Steinhagen, E., Shogan, B. D., Goldberg, J. E., Feingold, D. L., Lightner, A. L., & Paquette, I. M. (2022). Clinical practice guidelines for enhanced recovery after colon and rectal surgery from the American Society of colon and rectal surgeons and the society of American gastrointestinal and endoscopic surgeons. Surgical Endoscopy, 37(1), 5-30.

https://doi.org/10.1007/s00464-022-09758-x

12. Shahab, A., Razzaq, M. A., & Mahmood, M. M. (2016). Outcome of Early Versus Delayed Stoma Closure. trauma, 9, 30.

13. Mondal, U., Kar, A., & Majumdar, S. (2022). Complications following early and delayed ileostomy closure: An interventional study. INTERNATIONAL JOURNAL OF ANATOMY RADIOLOGY AND SURGERY.

https://doi.org/10.7860/ijars/2022/48843.2797

14. Tsai, K. Y., Tsai, W. S., Huang, S. H., Lai, I. L., Sun, C. Y., Cheng, C. C., ... & Chen, J. S. (2021). Surgical Outcome of Stoma Closure in IBD Surgery. J Soc Colon Rectal Surgeon (Taiwan), 32, 105-113.

https://www.crs.org.tw/data/journal/file/1736920508X0KUQ.pdf

15. Turner, G. A., Clifford, K. A., Holloway, R., Woodfield, J. C., & Thompson‐Fawcett, M. (2022). The impact of prolonged delay to loop ileostomy closure on postoperative morbidity and hospital stay: A retrospective cohort study. Colorectal Disease, 24(7), 854-861.

https://doi.org/10.1111/codi.16095

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Published

2025-06-30

How to Cite

Fareed, A., & Faraz, A. (2025). Outcome of Delayed Stoma Closure in Patients Presenting to Tertiary Care Hospital. Indus Journal of Bioscience Research, 3(6), 972-976. https://doi.org/10.70749/ijbr.v3i6.2021