• Yong-Geul Joh, Rolv-Ole Lindsetmo, Jonah Stulberg, Vincent Obias, Brad Champagne, and Conor P Delaney.
• Division of Colorectal Surgery, University Hospitals Case Medical Center, Cleveland, Ohio, USA.
• Dis. Colon Rectum. 2008 Dec 1;51(12):1786-9.

PurposeIn this study we evaluated the outcome of a standardized enhanced recovery program in patients undergoing ileostomy closure.MethodsForty-two patients underwent ileostomy closure by a single surgeon and were managed by a standardized postoperative care pathway. On the first postoperative day, patients received oral analgesia and a soft diet. Discharge was based on standard criteria previously published for laparoscopic colectomy patients. Results were recorded prospectively in an Institutional Review Board-approved database, including demographics, operative time, blood loss, complications, length of stay, and readmission data.ResultsThe median operative time and blood loss were 60 minutes and 17.5 mL, respectively, and median hospital stay was 2 days. Twenty-nine patients (69 percent) were discharged by postoperative Day 2. The complication rate was 23.8 percent; complications included prolonged postoperative ileus (n = 3), early postoperative small-bowel obstruction (n = 1), mortality not related to ileostomy closure (n = 1), minor bleeding (n = 1), wound infection (n = 1), incisional hernia (n = 1), diarrhea (n = 1), dehydration (n = 1). The 30-day readmission rate was 9.5 percent (n = 4). Two patients had reoperation within 30 days for small-bowel obstruction and a wound infection.ConclusionsIleostomy closure patients managed with postoperative care pathways can have a short hospital stay with acceptable morbidity and readmission rates.

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