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Purpose <p>The primary objective of a protective loop ileostomy is to facilitate uncomplicated healing of the anastomosis. However, it is associated with elevated morbidity, both during the protection and after ileostomy reversal. The present study evaluated the associated factors and significant complications associated with protective loop ileostomy and its reversal.</p> Materials and methods <p>A retrospective analysis was conducted on a cohort of 158 patients who underwent elective anterior low resection for rectal cancer with protective loop ileostomy. The study covered a period of six years, from January 2016 to December 2021.</p> Results <p>In all set up 41.1% of patients experienced complications related to their stoma, with associated factors hypertension (<i>p</i> = 0.019) and dyslipidemia (<i>p</i> = 0.003). The overall incidence of postoperative complications was 48.5%. However, the vast majority of these were minor. The most prevalent complication was Surgical Site Infection (25.9%), with total protein as an associated factor (OR = 2.881; 95% CI: 1.160–7.154; <i>p</i> = 0.023), followed by parastomal hernia, which occurred in 24.46% of patients. With associated factors: higher BMI score (OR 1.142; 95% CI 1.040–1.254, <i>p</i> = 0.006) and dyslipidemia (OR 2.531; 95% CI 1.113–5.785, <i>p</i> = 0.027). Other common complications included ileostomy care issues (10.8%), with associated factors being time to restoration (OR = 1.090; 95% CI: 1.003–1.183; <i>p</i> = 0.041), adjuvant oncotherapy (<i>p</i> = 0.047), mineral imbalance (8.9%), and diabetes (OR = 7.714; 95% CI: 2.002–29.72; <i>p</i> = 0.003).</p> Conclusion <p>A protective loop ileostomy is associated with a high complication rate. It is therefore essential to carefully weigh its indications and benefits for the patient during the preoperative decision-making process.</p>

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Complications Associated with Diverting Loop Ileostomy and Ileostomy Closure After Minimally Invasive Rectal Cancer Surgery: A Retrospective Single-Center Cohort Study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月22日

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  • Řezáč Tomáš,
  • Zbořil Pavel,
  • Klos Dušan,
  • Vrba Radek,
  • Špička Petr,
  • Klementa Ivo,
  • Starý Lubomír

摘要

Purpose

The primary objective of a protective loop ileostomy is to facilitate uncomplicated healing of the anastomosis. However, it is associated with elevated morbidity, both during the protection and after ileostomy reversal. The present study evaluated the associated factors and significant complications associated with protective loop ileostomy and its reversal.

Materials and methods

A retrospective analysis was conducted on a cohort of 158 patients who underwent elective anterior low resection for rectal cancer with protective loop ileostomy. The study covered a period of six years, from January 2016 to December 2021.

Results

In all set up 41.1% of patients experienced complications related to their stoma, with associated factors hypertension (p = 0.019) and dyslipidemia (p = 0.003). The overall incidence of postoperative complications was 48.5%. However, the vast majority of these were minor. The most prevalent complication was Surgical Site Infection (25.9%), with total protein as an associated factor (OR = 2.881; 95% CI: 1.160–7.154; p = 0.023), followed by parastomal hernia, which occurred in 24.46% of patients. With associated factors: higher BMI score (OR 1.142; 95% CI 1.040–1.254, p = 0.006) and dyslipidemia (OR 2.531; 95% CI 1.113–5.785, p = 0.027). Other common complications included ileostomy care issues (10.8%), with associated factors being time to restoration (OR = 1.090; 95% CI: 1.003–1.183; p = 0.041), adjuvant oncotherapy (p = 0.047), mineral imbalance (8.9%), and diabetes (OR = 7.714; 95% CI: 2.002–29.72; p = 0.003).

Conclusion

A protective loop ileostomy is associated with a high complication rate. It is therefore essential to carefully weigh its indications and benefits for the patient during the preoperative decision-making process.