Loop-ileostomy reversal in a 23-h stay setting is safe with high patient satisfaction

Abstract

Introduction

This study aimed to determine whether day-case closure of loop ileostomy with discharge within 23 h was both feasible and accepted by patients.

Materials and methods

We conducted a prospective pilot study where selected rectal cancer patients with diverting loop ileostomy underwent stoma closure in a 23-h stay setting. Patients were followed up on the third, seventh, and 30th postoperative day and phoned daily during the first week. A comparable group of 30 patients who underwent standard in-hospital stoma closure prior to the start of the study were selected retrospectively as historical controls.

Results

In total, 30 patients (median age, 67 years; range, 41–79 years) were included. All patients met discharge criteria and were discharged within 23 h of surgery, except one. In total, seven patients (23%) were admitted. Two of these patients underwent laparotomy because of anastomotic leakage and small bowel obstruction, respectively. The mean total length of stay was 1.7 days. Most patients (87%) were satisfied with the treatment without feeling neglected or anxious and preferred the 23-h stay setting. In the control group, the mean length of stay was 5 days. Seven patients (23%) were readmitted. Two of these patients underwent laparotomy because of small bowel obstruction and abscess, respectively.

Conclusion

Ileostomy closure in a 23-h stay setting in selected patients with meticulous follow up is feasible and safe with high patient satisfaction.

ClinicalTrials.gov number

(NCT02774447).

Keywords:

• Ileostomy closure;·ileostomy reversal
• diverting ileostomy closure
• day-case;·23-h stay
• patient experience

Acknowledgments

Special thanks to Malin Engdahl for her contributions.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the county of Västmanland [grant number LTV-943053].