A study of the morbidity associated with reversal of ileostomy following anterior resection complicated by a limited anastomtoic leak: P043

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Aim:Few studies report functional outcomes for anterior resection complicated by limited anastomotic leaks.Method:This was a retrospective study of 17 patients identified from reports of routine water soluble contrast enemas performed 1-4 months post operatively showing anastomotic leak.Results:Median age 71 years (range 46-88) with even distribution in ASA categories I, II and III. Indications for surgery were malignancy in 15 cases and diverticular disease in two cases. Mean time from anterior resection to reversal of ileostomy was 352 days (± 272). Fourteen patients underwent reversal after repeat contrast studies, seven of which showed a persistent leak at the last studyprior to reversal. There was no 30 day mortality following reversal of ileostomy and 3 (18%) cases of morbidity. Seven (41%) patients had persistent bowel frequency at 6 months and 6 (35%) at 12 months. Two patients had significant ano-rectal pain. One (6%) patient had to have a stoma reformed.Conclusion:Patients with leaks demonstrated on water contrast studies can be safely reversed with a small incidence of delayed pelvic sepsis and the need for a permanent stoma. Functional outcomes can be poor in this group for aprolonged period after surgery.

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