Closure of small bowel stomas on postoperative day 10

Abstract

Objective: To find out if early closure of a defunctioning small bowel stoma (day 10) was feasible and safe.

Design: Prospective non-randomised study.

Setting: University hospital, France.

Interventions: During a 42-month period (January 1998-June 2001), all patients with a temporary small bowel stoma were elected for early closure on postoperative day 10 in a non-randomised prospective study. The procedure was considered only if the patient was not taking steroids, was in good condition, and had not developed wound or general sepsis after the initial operation. Other patients' stomas were closed after the usually recommended delay (>8 weeks).

Main outcome measures: Postoperative complications, delay to recover bowel activity, and to resume oral feeding, and duration of hospital stay.

Results: Thirty-six patients were included in the study: 14 patients in the early group and 22 in the delayed group. There were no postoperative deaths. Three patients developed wound abscesses, two in the early group and one in the delayed group. The median (range) duration of hospital stay was longer in the delayed group: 36 (14-84) days, than in the early group: 22 (18-29) days (p < 0.01).

Conclusions: Small bowel stomas can be closed in selected healthy patients on postoperative day 10 without major complications.