LOOP ILEOSTOMY FOR TEMPORARY FECAL DIVERSION

The aim of this study was to prospectively assess the morbidity of creating and closing loop ileostomies in a consecutive series of patients having an ileoanal pouch procedure. Between 1983 and 1991, 203 patients had loop ileostomies created for temporary fecal diversion after an ileoanal pouch procedure. There was one death as a result of liver failure. One patient developed a persistent pouch-vaginal fistula that resulted in pouch excision. The remaining 201 patients had their ileostomies closed at a mean time of 10 weeks after the primary procedure. Only 7% needed surgery to correct ileostomy-related problems. After ileostomy closure, complications were noted in only 2% of patients. Loop ileostomy is easy to create and provides highly effective fecal diversion, which decreases the incidence of and mitigates the serious sequelae of pouch sepsis. Closure is simple, does not require a laparotomy, and is associated with few complications. Our experience with loop ileostomy for temporary fecal diversion after an ileoanal pouch procedure has been favorable. The loop ileostomy may be the stoma of choice for most clinical situations in which temporary fecal diversion is indicated.