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PTH-291 Open colorectal resection, major post-operative complications and high asa classification are associated with low reversal of ileostomy rates
  1. M Oliveira Cunha,
  2. MI Aslam,
  3. S Chaudhri
  1. Colorectal Surgery, University Hospitals of Leicester NHS Trust Leicester, UK

Abstract

Introduction Formation of defunctioning loop ileostomy after left hemicolectomy and anterior resection for colorectal cancer is a standard practice. Reversal of ileostomy is intended to be performed within 18 months after initial resection. However, this is not always feasible. This study aimed to evaluate closure rates according to ASA classification, Clavien-Dindo classification for surgical complications, laparoscopic and open surgery and age.

Method A prospectively maintained colorectal cancer database (January 2008 to December 2011) at University Hospitals of Leicester NHS Trust was analysed. The study population included all consecutive patients undergoing elective cancer resection where a defunctioning ileostomy was created. Length of time between cancer resection and closure of ileostomy was calculated.

Results 335 patients who underwent colorectal surgery with formation of defunctioning ileostomy were identified. Overall our closure of ileostomy rate was 69.2% for whole cohort, but 47.2% for patients aged above 80 years old. Median time between bowel resection and closure of ileostomy was 20.8 months (range 4.5 to 60 months). Patients that underwent open colorectal resection, aged above 80, developed major complications (Clavien-Dindo grade III and IV) post colorectal resection or patients with ASA III and IV had a lower rate of closure of ileostomy rate (p = 0.023, P < 0.01, p = 0.041 and p = 0.014 respectively).

Conclusion This study shows that patients that underwent open colorectal surgery, aged above 80 years old, with ASA grade III-IV or developed Clavien-Dindo grades III and IV had lower closure of ileostomy rates. Consideration for end colostomy should be given for patients aged above 80 in pre-operative setting.

Disclosure of interest None Declared.

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