Can physiological stimulation prior to ileostomy closure reduce postoperative ileus? A prospective multicenter pilot study

• Published in: Techniques in coloproctology 2022-08, Vol.26 (8), p.645-653
• Main Authors: Ocaña, J., García-Pérez, J. C., Labalde-Martínez, M., Rodríguez-Velasco, G., Moreno, I., Vivas, A., Clemente-Esteban, I., Ballestero, A., Abadía, P., Ferrero, E., Fernández-Cebrián, J. M., Die, J.
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Colorectal cancer; Colorectal Surgery; Gastroenterology; Medicine; Medicine & Public Health; Original Article; Ostomy; Physiology; Proctology; Surgery
• ISSN: 1123-6337; 1128-045X
• DOI: 10.1007/s10151-022-02620-1

Background The aim of this study was to assess the impact of ileostomy closure following preoperative physiological stimulation (PPS) on postoperative ileus (POI) in patients with loop ileostomy after low anterior resection for rectal cancer. Methods Patients who underwent ileostomy closure between January 2017 and February 2020 in two tertiary referral centers were prospectively included. PPS stimulation was compared to standard treatment. Stimulation was carried out daily during the 15 days prior to ileostomy closure by the patient's self-instillation of 200 ml of fecal contents from the ileostomy bag via the efferent loop, using a rectal catheter. Standard treatment (ST) consisted of observation. Outcomes measures were POI, morbidity, stimulation feasibility, and predictors to ileus. Results A total of 58 patients were included [42 males and 16 females, median age 67 (43–85) years]. PPS was used in 24 patients, who completed the entire stimulation process, and ST in 34 patients. No differences in preoperative factors were found between the two groups. POI was significantly lower in the PPS group (4.2%) vs the ST group (32.4%); p