Abstract
Objective: To compare incidence of postoperative complications among patients with enteric perforation in terms of early and late stoma closure.
Methods: This randomized controlled trial was conducted in the Department of General Surgery, Services Hospital Lahore, from 20th July 2022 to 19th January 2023. One hundred and forty-eight patients with ileostomy posts because of enteric perforation were scrutinized. The patients were divided in to two equal groups. Group A was subjected to early stoma closure in the 4-6 weeks whereas Group B had late closure in 3 months or later. Follow-ups were done on the patients two weeks post-reversal in order to determine complications such as anastomotic leak, skin excoriation, wound infection, bleeding, and long hospitalization.
Findings: The average age of patients was at 32.76 Years and the standard deviation was 7.14 Years. There were 100 males (67.57%) and 48 females (32.43%). Early closure compared to delayed closure had a significant difference in terms of anastomotic leak (2.70% vs. 10.81% p=0.049). Skin excoriation (6.76% vs. 18.92%; p=0.027), bleeding (2.70% vs. 13.51%; p=0.016), and prolonged hospital stay (12.16% vs. 27.03%; p=0.023) were also significantly reduced in the early closure group. There was less wound infection with early closure, but the difference was not significant (17.57 vs. 29.73; p=0.082).
Conclusion: Earlier stoma closure of 4-6 weeks has being linked to reduced number of postoperative complications compared to delayed closer in patients with enteric perforation and can be deemed safe in selected patients.