Impact of Temporary Protective Ileostomy on Intestinal Function and Quality of Life after a 2-Year Follow-up in Patients Who Underwent Colorectal Segmental Resection for Endometriosis

Diego Raimondo, Mattioli G, Giulia Mattioli, Eugenia Degli Esposti, Benedetta Gregori, Simona Del Forno, Manuela Mastronardi, Alessandro Arena, Arena A, Giulia Borghese, Marco Ambrosio, Ambrosio M, Renato Seracchioli
Journal of minimally invasive gynecology · 2019 · vol. 27(6) , pp. 1324–1330 · doi:10.1016/j.jmig.2019.10.017 · PMID:31672590 · W2982660863
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This study found that temporary protective ileostomy after colorectal resection for endometriosis did not significantly impact intestinal function or quality of life at a 2-year follow-up compared to patients without ileostomy.

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Abstract

Study objectiveTo compare 2-year follow-up intestinal function and quality of life (QoL) between women with temporary protective ileostomy (PI) and recanalization and women without PI after colorectal segmental resection for deep infiltrating endometriosis (DIE).DesignProspective observational exploratory study.SettingTertiary level referral center for minimally invasive gynecologic surgery.PatientsConsecutive patients who underwent laparoscopic colorectal resection and PI because of DIE between January 2015 and January 2018; an equal number of women without PI were matched according to age and anamnestic findings to serve as controls.InterventionsRealization of a PI or immediate recanalization in patients who underwent laparoscopic colorectal resection.Measurements and main resultsThirty-six patients were considered for the analyses: 18 in the PI group and 18 in the non-PI group. Baseline intestinal function and QoL were evaluated using 2 validated questionnaires. The main reasons for ileostomy were colpotomy (66.7%), ultralow bowel anastomosis (27.8%), concomitant ureteroneocystostomy, and positive Michelin test result (5.6%). The mean interval between first and second surgery in the PI group was 3.7 ± 1.7 months. Perioperative severe complications included 1 stenosis of colorectal anastomosis in 1 woman in the PI group and 1 perianastomotic abscess in the non-PI group; overall the complications were comparable between the 2 groups. At the 2-year follow-up from recanalization, bowel function and QoL improved from baseline, with no statistical differences between the groups (Knowles-Eccersley-Scott-Symptom delta: 5.9 ± 9.3 in the PI group vs 7.7 ± 10.2 in the non-PI group, p = .6; Gastrointestinal Quality of Life Index delta: 16.0 ± 27.5 vs 19.2 ± 24.7, p = .7).ConclusionTemporary PI after colorectal resection for DIE does not seem to influence patients' bowel function and QoL at a median follow-up from recanalization at 2 years.

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Condition tags

endometriosis

MeSH descriptors

Colonic Diseases Endometriosis Ileostomy Ileostomy Ileostomy Ileostomy Intestines Postoperative Complications Quality of Life Rectal Diseases Adult Case-Control Studies Colonic Diseases Colonic Diseases Digestive System Surgical Procedures Digestive System Surgical Procedures Endometriosis Endometriosis Female Follow-Up Studies

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