SAFETY OF EARLY VERSUS ROUTINE DISCHARGE FOLLOWING COLOURSOF TEMPORARY IIESTOMIES

Objective: The objective of this study was to compare safety of early versus routine discharge following closure of
temporary ileostomies.
Material and Methods: This prospective randomized control trial was conducted in surgical ‘A’ department of Lady
Reading Hospital Peshawar from January 2011 to December 2011 on all adult patients more than 14 years and less
than 70 years, either gender with temporary ileostomy for 6 weeks of initial surgery, normal distal loopogram and
serum albumin more than 2.5g/dl were included. All the patients with pre-existing stomal site wound infection,
reversal of stoma through laparatomy, comorbidities like D.M. Chronic liver disease, ischaemic heart diseases,
ureamic patients and patients recieved chemotherapy, radiations within six weeks were excluded. A total of 60
patients were allocated into two groups of 30 each randomly by lottery method. Group A were allowed to take clear
liquid within 24 hours and were discharged within 72 hours after operation from hospital. Group B who were kept “
nil by mouth “ in post operative period upto 72 hours and were discharged after 5 days from hospital. Safety was
evaluated by daily progress of both groups post-operatively for any complication and was noted. Data was compiled
and analyzed by using SPSS version 16.
Results: A total of 60 patients who had undergone ileostomies closure were divided into two groups randomly of
size 30 each. Group A contained early discharge ( within 72 hours ) and Group B contained routine discharge ( after
5th postoperative day ).
The age of the patients ranged from 20 to 68 years with mean age for group A was 38.46±1.222 years and for group
B was 40.9±1.35 years. The male to female ratio for group A was 3.2 to 1 and for group B was 2.8 to 1 .
The overall complications in group A was 33.3% and 20% in group B with P value 0.243. The postoperative compli-
cations were insignificant statistically. In this study no leak, fistula and mortality was documented in either group.
Conclusion: Early discharge after ileostomy reversal is safe, achievable and cost effective. It should be encouraged
as routine method of discharge to modify our practice where a large number of patients are waiting for admission.
Key Words: Ileostomy Reversal, Early Discharge, Safety.