TPTh 8.08 Reversal of Loop ileostomy in Anterior Resection (AR) in colorectal cancer: A cohort Study

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ID: 323905
2026
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Abstract
Abstract Aims Loop-ileostomy is commonly undertaken in 55% AR’s (mid & low-rectal-cancer), 38% remaining unclosed after-18 months (NBOCA-2025). Defunctioning-loop-ileostomy facilitates early-ERAS & rehabilitation, reduces-impact of post-operative-ileus & protective-in-anastomotic-leaks. Closure-of-loop ileostomy is usually undertaken after 3-months of AR. Aim of study was to assess the causes of delays in loop-ileostomy. Methods Cohort-study carried out since Jan’2007 to Jan’2026 at single institution. Descriptive demography & surgical outcomes were evaluated for all Anterior Resections with loop ileostomy. All AR’s without loop ileostomy were recruited as controls. Results AR-stoma(n=173) AR non stoma(n=323) Mann-Whitney-U(p-test) Age(yrs) 66.9±0.8 68.3±0.7 NS Sex(M:F) 109:64 193:130 NS ASA(median) 2±0.5 2±0.5 NS BMI 26.5±0.3 27.5±0.3 NS Lap(n) 113 253 <0.05 Op-time(mins)(index-op) 261.7±6.4 223.8±4.5 <0.0001 90-Day-mortality(n) 2 7 NS AL(n) 16 23 NS LN harvest (n) 16±5 18±6.5 NS Recurrence(n) 32 46 NS LOS(days)(index op) 9.5±4.5 6±3 <0.0001 Reversal(n) 123 Days-to-reversal 245±101 Reverse-op-time(mins) 85.0±4.5 Reversal-LOS (days) 6±3 Conclusion In our study defunctioning loop ileostomy was carried out in 34.9% of AR’s, loop ileostomy closures carried out in 71.1% of cases. Causes of “non closure” include CRC disease progression, continued adjuvant therapy, patient death or frailty, patient choice, anastomotic leaks or strictures, delays in anastomotic integrity checks, & theatre availability. Recruitment of CNS has assisted loop ileostomy closures (“close it quick” NBOCA 2025); planning after initial colorectal MDT & adjuvant therapy, preoperative investigations, theatre planning & counselling (i.e. LARS).
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Authors M A Gok, S Khan, K Riaz, M Bughio, H E Huguet, U A Khan
Journal the british journal of surgery
Year 2026
DOI
10.1093/bjs/znag087.510
URL
https://doi.org/10.1093/bjs/znag087.510
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