OUTCOMES OF EARLY VERSUS DELAYED ILEOSTOMY REVERSAL IN PATIENTS OF INTESTINAL PERFORATION

Abstract

Background: Ileostomy reversal is a common procedure following intestinal perforation, aimed at restoring gastrointestinal function. The timing of ileostomy reversal (early vs. delayed) has been a subject of debate regarding its impact on postoperative outcomes. Objective: This study aimed to compare the outcomes of early versus delayed ileostomy reversal in patients with intestinal perforation. Methods: This descriptive case series was conducted at the Department of General Surgery, Lahore General Hospital, involving 90 patients who underwent ileostomy reversal due to intestinal perforation. The patients were divided into two groups: the early group (reversal within 3 months of creation) and the delayed group (reversal after 3 months). Data were collected at multiple  points: preoperatively, during surgery, postoperatively at discharge, and during 30-day follow-up visits. Results: The early group (n=45) demonstrated significantly faster recovery compared to the delayed group (n=45), with a mean return to normal activity of 21.3 ± 4.5 days versus 26.7 ± 5.9 days (p = 0.01) and a shorter time to return to work (35.2 ± 6.4 days vs. 42.1 ± 7.1 days, p = 0.04). Additionally, 55.6% of the early group reported satisfactory recovery, compared to 40% of the delayed group (p = 0.05). The early group also had a higher postoperative quality of life score (80.4 ± 5.2 vs. 75.3 ± 6.9, p = 0.03). However, no significant differences were observed in complication rates, length of hospital stay, or postoperative pain scores. Conclusions: It is concluded that early ileostomy reversal leads to faster recovery and better patient satisfaction, with improved quality of life compared to delayed reversal.