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Day-case closure of ileostomy: feasible, safe and efficient

Bhalla, Ashish; Peacock, O.; Tierney, G.M.; Tou, S.; Hurst, N.G.; Speake, W.J.; Williams, John P.; Lund, Jonathan N.

Authors

Ashish Bhalla

O. Peacock

G.M. Tierney

S. Tou

N.G. Hurst

W.J. Speake

John P. Williams

Jonathan N. Lund



Abstract

Aim

Over 5000 loop ileostomy closures were performed in the UK in 2013 with a median inpatient stay of 5 days. Previously we have successfully implemented a 23-h protocol for loop ileostomy closure which was modified for same-day discharge. We present our early experience of day-case loop ileostomy closure.
Method

A specific patient pathway for day-case discharge following loop ileostomy closure was implemented with inclusion criteria to conform with British Association of Day Surgery guidelines. Exclusion criteria included postoperative chemoradiotherapy, multiple comorbidities and social care needs. Follow-up consisted of telephone contact (24 and 72 h after discharge) and a routine outpatient appointment. Patients were provided with a 24-h contact point in case of emergency.
Results

Fifteen (12 male) patients were enrolled of median age 67 (39–80) years. The median operating time was 41 (23–80) min. The indication for ileostomy formation was to cover a low anterior resection for adenocarcinoma (13), reversal of Hartmann's procedure (1) and functional bowel disorder (1). The median interval from the primary procedure to day-case loop ileostomy closure was 8 (3–14) months. Every patient was discharged on the day of surgery. There were no complications related to the surgery and there was one readmission due to a urinary tract infection. The median length of follow-up was 4 (2–16) months.
Conclusion

Our early experience shows that day-case loop ileostomy closure is feasible, safe and efficient. This protocol will become standard within our institution for suitable patients, saving on average five inpatient bed days per patient.

Citation

Bhalla, A., Peacock, O., Tierney, G., Tou, S., Hurst, N., Speake, W., …Lund, J. N. (2015). Day-case closure of ileostomy: feasible, safe and efficient. Colorectal Disease, 17(9), doi:10.1111/codi.12961

Journal Article Type Article
Acceptance Date Mar 25, 2015
Online Publication Date Aug 8, 2015
Publication Date Sep 1, 2015
Deposit Date Aug 1, 2017
Publicly Available Date
Journal Colorectal Disease
Print ISSN 1462-8910
Electronic ISSN 1463-1318
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 17
Issue 9
DOI https://doi.org/10.1111/codi.12961
Keywords Day-case; reversal of ileostomy; enhanced recovery
Public URL http://eprints.nottingham.ac.uk/id/eprint/44542
Publisher URL http://onlinelibrary.wiley.com/doi/10.1111/codi.12961/abstract
Copyright Statement Copyright information regarding this work can be found at the following address: http://eprints.nottingh.../end_user_agreement.pdf