Impact of Early and Delayed Stoma Closure on Patients and Their Family Life: Early vs Delayed Stoma Closure Outcomes

Tahira Karim; Dileep Kumar; Anum Iftikhar; Mehwish Imtiaz; Naib Ali

doi:10.54393/pjhs.v7i5.3794

Authors

Tahira Karim Department of General Surgery, Jinnah Postgraduate Medical Center, Karachi, Pakistan
Dileep Kumar Department of General Surgery, Jinnah Postgraduate Medical Center, Karachi, Pakistan
Anum Iftikhar Department of General Surgery, Jinnah Postgraduate Medical Center, Karachi, Pakistan
Mehwish Imtiaz Department of General Surgery, Jinnah Postgraduate Medical Center, Karachi, Pakistan
Naib Ali Department of General Surgery, Jinnah Postgraduate Medical Center, Karachi, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v7i5.3794

Keywords:

Stoma Closure, Early and Delayed Reversal, Ileostomy, Colostomy, Psychosocial Effects, Post-Operative Outcomes

Abstract

Temporary intestinal stomas are to preserve the distal anastomosis following colorectal surgery. Although stoma reversal is necessary to provide bowel continuity, the time of closure is debatable. Early closure might be more beneficial by minimizing stoma complications, hospitalization, and adverse psychosocial effects. Objectives: To compare clinical outcomes and psychosocial effects of early versus delayed stoma closure in patients with temporary stomas. Methods: This retrospective cohort study was done in the Surgical Wards of Jinnah Postgraduate Medical Centre (JPMC), Karachi, and involved 81 patients whose intestinal stoma was reversed. Patients were sorted into two groups: early closure (less than 6 weeks; n=40) and delayed closure (more than 6 weeks; n=41). The analysis of data was performed with the help of SPSS version 26. The p-value of 0.05 was taken to be statistically significant. Results: A total of 81 patients were included, with 40 undergoing early and 41 delayed stoma closure. Baseline characteristics were comparable between groups. Early closure was associated with shorter hospital stay (4.3 ± 1.9 vs 7.1 ± 2.4 days) and earlier resumption of oral intake (2.8 ± 1.2 vs 4.9 ± 1.8 days). Overall, postoperative complications were lower after early closure (17.5% vs 36.5%), particularly wound infection (10.0% vs 22.0%). Delayed closure showed higher psychological stress and greater socioeconomic burden. Conclusions: An earlier stoma closure had better clinical and psychosocial outcomes than a late stoma closure, which were characterized by quicker recovery.

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