In individuals who need a colectomy due to ulcerative colitis, the benefits of a diverting loop ileostomy with IPAA construction are debatable. The purpose of this research was to ascertain whether or not the absence of a diverting loop ileostomy during ileal pouch-anal anastomosis (IPAA) installation increased the likelihood of problems. The research was carried out in a tertiary care facility with inflammatory bowel disease (IBD) program because of its large patient load. Patients with ulcerative colitis who had IPAA with or without ileostomy. Patients who had a diverting ileostomy at the time of IPAA development were compared to those who had a stoma-free IPAA with regard to anastomotic leak rate and pouch failure rate. Only 91 of the total 414 participants in the research did not need a stoma for IPAA. Patients with IPAA without a stoma were less likely to be on prednisone and saw less blood loss compared to those with IPAA, who also had a diverting loop ileostomy. There was no significant difference in anastomotic leak rate or long-term pouch failure rates between stoma-less IPAA and IPAA with diverting loop ileostomy. When the stoma is reversed, there is a 14.6% increased risk of complications in patients with diverting loop ileostomies. This research provides evidence that, for certain IPAA patients, it is possible to avoid performing a diverting ileostomy. Properly chosen individuals undergoing stoma-free IPAA do not have an increased risk of anastomotic leak or pouch failure compared to IPAA using a diverting loop ileostomy. While diverting loop ileostomies are generally considered safe, there are specific hazards associated with them that may outweigh the benefits.

 

Source: journals.lww.com/dcrjournal/Abstract/2022/11000/Stoma_less_IPAA_Is_Not_Associated_With_Increased.10.aspx