Safety of short stay Hospitalization in Reversal of Loop Ileostomy

Tayyab  Abbas; Abid  Nazir; Muhammad  Lateef; Faisal  Rauf; Zafar Ali Choudhary

doi:10.29054/apmc/2012.492

Tayyab Abbas Associate Professor of Surgery AIMC/Jinnah Hospital, Lahore
Abid Nazir Senior Registrar Surgery AIMC/Jinnah Hospital, Lahore
Muhammad Lateef Registrar Surgery AIMC/Jinnah Hospital, Lahore
Faisal Rauf Postgraduate Resident AIMC/Jinnah Hospital, Lahore
Zafar Ali Choudhary Professor of Surgery AIMC/Jinnah Hospital, Lahore

DOI: https://doi.org/10.29054/apmc/2012.492

Keywords: Ileostomy reversal-short stay

Abstract

Study Design: Prospective, randomized Place: Surgical-3 Jinnah Hospital/ Allama Iqbal Medical College, Lahore. Duration: Two years, January2009-December 2011. Methods: Patients between 10-50 years, waiting for ileal stoma reversal were re-investigated and were prepared on out door basis. Admissions were done one day before operation of stoma reversal. All operations were undertaken on elective lists by the same grade of surgeons. Patients were randomly allocated one of the two groups. Each group consisted of 60 patients. Group-1 patients were allowed to take clear liquids 4 hours after surgery and fluid diet was given on first postoperative day and were discharged from hospital 24 hours after operation. Patients of group-2 were kept NPO for 4 days with nasogatric tube in situ. Clear fluids were allowed on 4^th postoperative day. Fluid diet was permitted on 5^th postoperative day and were discharged from hospital on 6-7^th postoperative day. Inclusion criteria: Loop ileostomy. Exclusion criteria: End ileostomy, Extremes of age. Results: Sample size of the research was 120 patients with random divisionin two groups. Group-1 consisted of 60 patients undergoing protocol of short stay hospitalization whereas 60 patients of group-2 were managed with conventional method of intravenous fluid and nil by mouth for 4-5 day. The demographic characteristics of group-1 and group-2 were similar. The indications of constructing of ileostomy were abdominal tuberculosis, typhoid perforation, obstetrical trauma, firearm injury, iatrogenic intestinal injury during adhenolysis and strangulated hernia with gangrenous intestine. The indications were almost identical in both groups. Majority of patients of group-1(70%) were able to go home on first postoperative day with total hospital stay of 2 days. In group-2, 66.6% of the total patients had hospital stay of 8 days with p value of .674 (p=.674) which is insignificant statistically. Similarly the statistics of postoperative complications were similar with p value of .805 (p=.805) which is again not significant. Conclusion: Short stay hospitalization is safe and feasible in majority of the patients undergoing ileostomy reversal.