Early versus late closure of protective ileostomy after rectal cancer surgery.
Int J Colorectal DisSep 10, 2026 (epub)
Elias Khajeh, Andrea Sosková, Johanna Fellhofer-Hofer et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the timing of protective ileostomy closure after rectal cancer surgery, comparing early closure (≤ 30 days) to late closure (≥ 12 weeks) in 387 patients. The study found no significant differences in major postoperative outcomes, but early closure was associated with a shorter time to first passage of flatus and significant cost reductions.
Key findings
- Early closure showed a tendency for shorter time to first passage of flatus (p < 0.001).
- Significant cost reductions were observed in the early closure group for stoma bags (p < 0.001).
- Total costs at 12 months were significantly lower in the early closure group (p < 0.001).
- No significant differences were found in overall postoperative morbidity or major complications.
Why it matters
Understanding the optimal timing for ileostomy closure can help clinicians make informed decisions that may enhance patient recovery and reduce healthcare costs. This study provides evidence supporting early closure as a viable option in selected patients.