%0 Journal Article
%A Ocaña, Juan
%A Labalde Martínez, María
%A Vivas, Alfredo
%A Ferrero Herrero, Eduardo
%A Die, Javier
%T Can physiological stimulation prior to ileostomy closure reduce postoperative ileus: a prospective multicenter pilot study
%D 2022
%@ 1123-6337
%U https://hdl.handle.net/20.500.14352/98915
%X Background The aim of this study was to assess the impact of ileostomy closure following preoperative physiologicalstimulation (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 centerswere prospectively included. PPS stimulation was compared to standard treatment. Stimulation was carried out daily duringthe 15 days prior to ileostomy closure by the patient's self-instillation of 200 ml of fecal contents from the ileostomy bag viathe 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 24patients, who completed the entire stimulation process, and ST in 34 patients. No differences in preoperative factors werefound between the two groups.POI was significantly lower in the PPS group (4.2%) vs the ST group (32.4%); p < 0.01, OR: 0.05 (CI 95% 0.01–0.65). ThePPS group had a shorter time to restoration of bowel function (1 day vs 3 days) p = 0.02 and a shorter time to tolerance ofliquids (1 day vs 2 days), p = 0.04. Age (p = 0.01), open approach at index surgery, p = 0.03, adjuvant capecitabine (p = 0.01).and previous abdominal surgeries (p = 0.02) were associated with POI in the multivariate analysis. C-reactive-protein valueson the 3rd (p = 0.02) and 5th (p < 0.01) postoperative day were also associated with POI.Conclusions PPS for patients who underwent ileostomy closure after low anterior resection for rectal cancer is feasible andmight reduce POI.
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