Özet:

Aim: Although various techniques for diverting ileostomy reversal have been described, the best surgical technique for closure of loop ileostomy has not been determined yet. A diverting ileostomy reversal can be accomplished by a hand-sewn or stapled anastomosis after resection of a segment of the small bowel or with the fold-over technique. This study aimed to compare the outcomes of ileostomy reversal using the end-to-end, hand-sewn anastomosis and the fold-over technique. Method: Patients whose ileostomies were closed at the same university hospital between January 2011 and September 2015 were analysed retrospectively. Only patients with hand-sewn anastomosis or fold-over technique were included in the study. Patients in both groups were compared for postoperative complications, requirement for reoperation, readmissions, length of hospital stay, and mortality. Results: A total of 43 consecutive patients who underwent ileostomy closure between January 2011 and September 2015 were analyzed. The median age of the study cohort was 58 (24-84) years. Thirty-four patients (79%) were male. Twenty-one (49%) were operated for colorectal cancer while the others were operated because of benign diseases. Ileostomy closure with the fold-over technique was done in 15 patients and an end-to-end anastomosis in 22 patients. No significant differences were found among patients whose ileostomies were closed with fold-over technique and those who had resection with an end-to-end anastomosis in terms of duration of hospital stay, postoperative complications, requirement for reoperation, readmissions, and mortality. Conclusion: Resection and hand-sewn anastomosis is as safe as the fold-over technique for closing a diverting ileostomy and may be preferable in terms of reducing surgery times when chosen as a primary closure method.

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