Early Versus Delayed Closure of Covering Ileostomy after Low Anterior Resection for Ectal Carcinoma | ||
| The Egyptian Journal of Surgery | ||
| Volume 44, Issue 3, July 2025, Pages 1070-1076 PDF (556.67 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejsur.2025.350937.1349 | ||
| Authors | ||
| Mohammed Abdo Etman* ; Alaa Abd El-Azeem Elsisi; Ahmed Sabry ELgammal; Asem Fayed Moustafa; Ahmed Said El-Kelany | ||
| Department of Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt | ||
| Abstract | ||
| Background: This study aimed to assess the outcomes of low anterior resection (LAR) for rectal cancer, comparing early versus delayed loop ileostomy closure. Morbidity, mortality, and quality of life scores throughout a 12-month postoperative period were the main emphasis. Patients and Methods: Between January 2023 and 2024, 32 patients with rectal cancer who had treatment at Menoufia University Hospital with LAR and temporary covering ileostomy participated in a prospective clinical research. Early closure (14 days postsurgery) and delayed closure (2 months postsurgery) were the two equal groups into which the patients were randomly assigned. Operative details, postoperative complications, and quality of life assessments at 2, 6, and 12 months following surgery were among the important characteristics assessed. Results: A total of 15 out of 32 patients were excluded from the study due to anastomotic leak, unstable medical state, or loss to follow-up. The two groups did not differ significantly in terms of surgical data, complications, or baseline characteristics. However, these differences were not statistically significant (P= 0.094, P= 0.071, P= 0.462). At 2, 6, and 12 months postoperatively, the early closure group’s quality-of-life (QoL) scores were slightly higher than those of the delayed closure group (mean scores: 102.13 vs. 96.81, 107 vs. 102.5, and 109.56 vs. 108.19, respectively). Factors including age, sex, comorbidities, type of surgery, and timing of closure did not significantly correlate with QoL outcomes at 12 months, according to linear regression analysis. Conclusion: When compared with delayed closure, early loop closure had no discernible impact on postoperative QoL in patients undergoing LAR for rectal cancer, ileostomy. The incidence of complications and operative results were comparable for both closure techniques. To validate these findings, more research with larger sample sizes is required. | ||
| Keywords | ||
| Early closure; Delayed closure; Loop ileostomy; Low anterior resection; Morbidity; Mortality; Postoperative outcomes; Quality of life; Rectal cancer | ||
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