Standardized postoperative pathway: Accelerating recovery after ileostomy closure

Yong Geul Joh, Rolv Ole Lindsetmo, Jonah Stulberg, Vincent Obias, Brad Champagne, Conor P. Delaney

Research output: Contribution to journalArticlepeer-review

43 Scopus citations

Abstract

PURPOSE: In this study we evaluated the outcome of a standardized enhanced recovery program in patients undergoing ileostomy closure. METHODS: Forty-two patients underwent ileostomy closure by a single surgeon and were managed by a standardized postoperative care pathway. On the first postoperative day, patients received oral analgesia and a soft diet. Discharge was based on standard criteria previously published for laparoscopic colectomy patients. Results were recorded prospectively in an Institutional Review Board-approved database, including demographics, operative time, blood loss, complications, length of stay, and readmission data. RESULTS: The median operative time and blood loss were 60 minutes and 17.5 mL, respectively, and median hospital stay was 2 days. Twenty-nine patients (69 percent) were discharged by postoperative Day 2. The complication rate was 23.8 percent; complications included prolonged postoperative ileus (n=3), early postoperative small-bowel obstruction (n=1), mortality not related to ileostomy closure (n=1), minor bleeding (n=1), wound infection (n=1), incisional hernia (n=1), diarrhea (n=1), dehydration (n=1). The 30-day readmission rate was 9.5 percent (n=4). Two patients had reoperation within 30 days for small-bowel obstruction and a wound infection. CONCLUSIONS: Ileostomy closure patients managed with postoperative care pathways can have a short hospital stay with acceptable morbidity and readmission rates.

Original languageEnglish (US)
Pages (from-to)1786-1789
Number of pages4
JournalDiseases of the colon and rectum
Volume51
Issue number12
DOIs
StatePublished - Dec 1 2008

Keywords

  • Hospital stay
  • Ileostomy closure
  • Postoperative ileus

ASJC Scopus subject areas

  • Gastroenterology

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