Evidence map›Paper›PMID 19221766›Full record

SynthesisInternational journal of colorectal disease2009

The morbidity surrounding reversal of defunctioning ileostomies: a systematic review of 48 studies including 6,107 cases.

Andre Chow, Henry S Tilney, Paraskevas Paraskeva, Santhini Jeyarajah, Emmanouil Zacharakis, Sanjay Purkayastha

4 registry-linked trialsAbstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in International journal of colorectal disease, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 180 papers, 23 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
180citing papers in PubMed, 23 pooled it
6.2field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02279771 naunknown statusnot on this mapstarted 2015, after this paper: background citation

Multicenter Randomized Controlled Trial of Transanal Reinforcement of Low Rectal Anastomosis Versus Protective Ileostomy in the Prevention of Anastomotic Leak After Rectal Cancer Surgery

TypeinterventionalSponsorDonato F AltomareRan2015 to 2022Enrolled140ConditionsRectal CancerArmstransanal anastomotic reinforcement, protective ileostomy group, a circular anal dilator (CAD)
NCT03941522 naunknown statusnot on this mapstarted 2019, after this paper: background citation

Loop Ileostomy Closure as a 23-hour Stay Procedure, a Multi-center Randomized Controlled Trial

TypeinterventionalSponsorCHU de Quebec-Universite LavalRan2019 to 2021Enrolled168ConditionsIleostomy - StomaArmsEarly discharge from hospital
NCT04372992 naterminatednot on this mapstarted 2020, after this paper: background citation

Multicenter Randomized Controlled Phase III Trial Comparing Ileostomy Closure Before or After Adjuvant Therapy in Patients Operated for Rectal Cancer

TypeinterventionalSponsorOspedale Umberto I di TorinoRan2020 to 2022Enrolled14ConditionsIleostomy, Rectal CancerArmsTiming of stoma closure
NCT06157645 nacompletednot on this mapstarted 2024, after this paper: background citation

Prophylactic Onlay Mesh Reinforcement vs Anatomical Closure in Stoma Reversal: A Randomized Controlled Trial

TypeinterventionalSponsorAssiut UniversityRan2024 to 2025Enrolled62ConditionsIncisional Hernia, Surgical Site Infection, Postoperative Pain, Hospital Stay, Length of Stay in Hospital From Surgery to DischargeArmsProlene mesh
3 · Its place in the literature

Who cites it

180 citing papers in PubMed, 23 syntheses or guidelines pooled it, 424 citations in OpenAlex.

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  13. Systematic review and meta-analysis of incisional hernia post-reversal of ileostomy.Hernia : the journal of hernias and abdominal wall surgery · 2020
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  18. Morbidity of loop ileostomy closure after restorative proctocolectomy for ulcerative colitis and familial adenomatous polyposis: a systematic review.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2014
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120 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Andre ChowDepartment of BioSurgery & Surgical Technology, Imperial College London, 10th Floor, QEQM Building, St Mary's Hospital Campus, Praed Street, London, W2 1NY, UK.
Henry S Tilney
Paraskevas Paraskeva
Santhini Jeyarajah
Emmanouil Zacharakis
Sanjay Purkayastha
Imperial College London · GBSt Mary's Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsLoop ileostomies are used currently in surgical practice to reduce the consequences of distal anastomotic failure following colorectal resection. It is often assumed that reversal of a loop ileostomy is a simple and safe procedure. However, many studies have demonstrated high morbidity rates following loop ileostomy closure. The aims of this systematic review were to examine all the existing evidence in the literature on morbidity and mortality following closure of loop ileostomy.

methodA literature search of Ovid, Embase, the Cochrane database, Google Scholar and Medline using Pubmed as the search engine was used to identify studies reporting on the morbidity of loop ileostomy closure (latest at June 15th 2008), was performed. Outcomes of interest included demographics, the details regarding the original indication for operation, operative and hospital-related outcomes, post-operative bowel-related complications, and other surgical and medical complications.

resultsForty-eight studies from 18 countries satisfied the inclusion criteria. Outcomes of a total of 6,107 patients were analysed. Overall morbidity following closure of loop ileostomy was found to be 17.3% with a mortality rate of 0.4%. 3.7% of patients required a laparotomy at the time of ileostomy closure. The most common post-operative complications included small bowel obstruction (7.2%) and wound sepsis (5.0%).

conclusionThe consequences of anastomotic leakage following colorectal resection are severe. However, the consequences of stoma reversal are often underestimated. Surgeons should adopt a selective strategy regarding the use of defunctioning ileostomy, and counsel patients further prior to the original surgery. In this way, patients at low risk may be spared the morbidity of stoma reversal.

Indexed as

IleostomyHospitalsHumansLaparotomy

Identifiers

PMID19221766
OpenAlexW1997788043

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.