Idiopathic constipation is a rare indication for ileostomy construction.
Dr Scarpa and colleagues evaluated the success of ileostomy in treatment of severe constipation.
The researchers also analyzed the surgical complications and re-operation rate to identify any factors potentially predictive of outcome.
The investigators conducted a retrospective study that analyzed the long-term outcome of 24 ileostomies constructed for constipation.
The team performed ileostomy construction in 13 patients during large bowel/rectum resection, in 6 after a full laparotomy and in 5 through an abdominal wall trephine alone.
The research team evaluated the surgical complications and the re-operation rate according any factors potentially predictive of outcome.
|Ileostomy patients for constipation should have loop ileostomy through a trephine rather than laparotomy|
The investigators reported that 1 patient had persistent constipation after stoma creation.
The researchers found that surgical complications occurred in 11 patients, retraction in 6, peristomal sepsis in 3 and parastomal hernia in 2.
The team noted that refashioning of the stoma was necessary in 7 patients.
Previous abdominal surgery, end ileostomy, ileostomy constructed after large bowel resection or laparotomy were associated with a significantly higher incidence of stomal complications.
The researchers also observed that age, duration of follow up, major complication and ileostomy created after bowel resection were associated with a significantly higher re-operation rate.
In addition, the team identified end ileostomy and ileostomy created after bowel resection as independent risk factors for surgical complication and re-operation, respectively, using multivariate analysis.
Dr Scarpa’s team concluded, “Ileostomies were associated with a high frequency of complications, but most could be managed by minor surgical interventions.”
“Patients who are considered for an ileostomy for severe idiopathic constipation should, where possible, have a loop ileostomy through a trephine rather than a laparotomy.”