Abstract

Aim: This study aimed to investigate the predictors associated with the ileostomy related complications after ileostomy closure among the patients with rectal cancer who underwent temporary diverting ileostomy following total mesorectal excision.

Method: A retrospective study included 151 patients who underwent total mesorectal excision for rectal cancer with ileostomy closure following temporary diverting ileostomy. Patients’ demographic characteristics, clinical and laboratory findings, and the major and minor ileostomy complications were evaluated by univariate and multivariate analysis.

Results: The mean age was 61.13 ± 13.33 years old. The population of data included 95 (62.9%) male patients. Adenocarcinoma was diagnosed in 149 (98.7%) patients. The duration of ileostomy was 197.3 ± 136.3 days. The patients who received neoadjuvant therapy were 52.3%. The patients with major ileostomy surgical site complications were more likely to have colorectal anastomosis leakage and intraabdominal pelvic abscess (17.72% vs 0% and 25.32% vs 0%, respectively; p < 0.001) whereas patients with minor complications were more likely to have colorectal anastomosis stenosis and intraabdominal pelvic abscess (18.67% vs 5.26% and 20.0% vs 6.58%, respectively; p < 0.05). Deep incisional, organ space and superficial SSIs were significantly higher in patients with both major and minor ileostomy complications (p<0.001) comparing to those who had no complications. Higher duration of ileostomy significantly increased the risks of major (OR 1.015, 95% CI, 1.007-1.022, p<0.001) and minor complications (OR 1.006, 95% CI 1.002-1.011, p=0.008).

Conclusion: Ileostomy duration was analyzed as a continuous variable and demonstrated a significant association with SSI risk. While prior literature suggests a 3-month threshold, our data support a progressive increase in risk with longer duration, rather than a strict cutoff.

Keywords: ileostomy, colorectal surgery, surgical site infection

License

Copyright (c) 2026 The Author(s). This is an open access article distributed under the Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

How to Cite

1.
Altınel Y, Aktimur YE, Tokocin M, Meriç S, Yiğitbaş H, Yavuz E. Predictors of the major and minor ileostomy complications following ileostomy closure in rectal cancer patients: a retrospective cohort study. J Trends Med Invest. 2026;2(1):18-30. https://doi.org/10.64512/JTMI.2026.25

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