Early Versus Delayed Closure of Covering Ileostomy after Low Anterior Resection for Ectal Carcinoma

Document Type : Original Article

Authors

Department of Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt

10.21608/ejsur.2025.350937.1349

Abstract

Background: This study aimed to assess the outcomes of low anterior resection (LAR) for rectal cancer, comparing
early versus delayed loop ileostomy closure. Morbidity, mortality, and quality of life scores throughout a 12-month
postoperative period were the main emphasis.
Patients and Methods: Between January 2023 and 2024, 32 patients with rectal cancer who had treatment at Menoufia
University Hospital with LAR and temporary covering ileostomy participated in a prospective clinical research. Early
closure (14 days postsurgery) and delayed closure (2 months postsurgery) were the two equal groups into which the
patients were randomly assigned. Operative details, postoperative complications, and quality of life assessments at 2, 6,
and 12 months following surgery were among the important characteristics assessed.
Results: A total of 15 out of 32 patients were excluded from the study due to anastomotic leak, unstable medical state,
or loss to follow-up. The two groups did not differ significantly in terms of surgical data, complications, or baseline
characteristics. However, these differences were not statistically significant (P= 0.094, P= 0.071, P= 0.462). At 2, 6,
and 12 months postoperatively, the early closure group’s quality-of-life (QoL) scores were slightly higher than those of
the delayed closure group (mean scores: 102.13 vs. 96.81, 107 vs. 102.5, and 109.56 vs. 108.19, respectively). Factors
including age, sex, comorbidities, type of surgery, and timing of closure did not significantly correlate with QoL outcomes
at 12 months, according to linear regression analysis.
Conclusion: When compared with delayed closure, early loop closure had no discernible impact on postoperative QoL
in patients undergoing LAR for rectal cancer, ileostomy. The incidence of complications and operative results were
comparable for both closure techniques. To validate these findings, more research with larger sample sizes is required.

Keywords

The Egyptian Journal of Surgery
Volume 44, Issue 3
July 2025
Pages 1070-1076

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