Increased postoperative complications after protective ileostomy closure delay: An institutional study

Table 1 Characteristics of the 93 patients who underwent loop ileostomy reversal

Clinical characteristics	n (%)
Patients included, total	93 (100)
Gender
Male	54 (58)
Female	39 (42)
BMI
Underweight	3 (3.1)
Normal weight	44 (47)
Overweight	31 (33.3)
Obese	15 (15.8)
ASA Index
I	5 (5.5)
II	59 (63)
III	29 (31)
Indication for ileostomy
Colorectal cancer	52 (56)
Anastomotic leak	16 (17.2)
IBD	6 (6.4)
Colectomy for polyposis	5 (5.3)
Endometriosis	5 (5.3)
Diverticular disease	3 (3.2)
Intestinal necrosis	1 (1.07)
Pelvi-peritonectomy	1 (1.07)
Post-endoscopy perforation	1 (1.07)
Trauma	1 (1.07)
Adjuvant therapy (in oncological patients)
Chemotherapy	16 (17.2)
Chemo-radiotherapy	35 (37)

Demographic data, BMI, ASA Index, indications for ileostomy creation and adjuvant therapy. BMI: Body mass index; ASA: The American Society of Anesthesiologists classification for operative risk; IBD: Inflammatory bowel disease.

Table 2 Characteristics of the ileostomy reversal procedure, including surgical technique and skin closure

Surgical variable	n (%)
Ileostomy closure technique	93 (100)
Stapled anastomosis	9 (9.7)
Handsewn anastomosis	84 (90.3)
Side-to-side with resection	28 (33.3)
End-to-end with resection	8 (9.5)
End-to-end without resection	48 (57.1)
Skin closure technique	70 (100)
Staples	17 (24)
Subcuticular	29 (41)
Interrupted suture	24 (34)

Table 3 Postoperative complications after loop ileostomy reversal in our study

Complications	n (%)
Total patients	38 (40.8)
Ileus	12 (12.9)
Wound infection	12 (12.9)
Rectal bleeding	5 (5.8)
Pseudomembranous colitis	4 (4.3)
Anemia/bleeding	3 (3.2)
Intestinal obstruction	3 (3.2)
Anastomotic leak	2 (2.15)
Urinary tract infection	2 (2.15)
Acute renal failure	2 (2.15)
Abdominal abscess	2 (2.15)
Pneumonia	1 (1)
Intestinal necrosis	1 (1)
Multiple organ failure	1 (1)
Thromboembolism	1 (1)
Sepsis	1 (1)
Evisceration	1 (1)
Clavien-Dindo classification
Grade I	21 (55)
Grade II	9 (24)
Grade III	7 (18)
Grade IV	0 (0)
Grade V	1 (3)

Total number of patients and detailed complications classified by the Clavien-Dindo classification.

Table 4 Statistically significant conditions/complications in the multivariate analysis and their specific P values

Condition/complication	Statistical significance
Gender (male) and overall complications	P = 0.042
Gender (male) and wound infection	P = 0.007
Age and rectal bleeding	P = 0.006
Complications and time to closure (months)	P = 0.041
Closure > 6 mo and pseudomembranous colitis	P = 0.003
End-to-end intestinal anastomosis (without resection) and postoperative ileus	P = 0.037