Clinical effectiveness analysis of laparoscopic loop ileostom closure: a single-center retrospective study

[Objectives] To compare the safety and feasibility of laparoscopic ileostomy reversal versus traditional open ileostomy reversal. [Methods] A retrospective analysis was conducted on the clinical data of 57 patients who underwent prophylactic loop ileostomy due to colorectal surgery at Qingdao Eighth People’s Hospital Affiliated to Shandong Second Medical University from June 2020 to June 2024. According to the different surgical methods, they were divided into the laparoscopic group (treated with laparoscopic ileostomy reversal surgery, n＝27) and the open group (treated with traditional open ileostomy reversal surgery, n＝30). The intraoperative (operative time, intraoperative blood loss, surgical incision length) and postoperative conditions (first postoperative exhaust time, postoperative pain level, postoperative hospitalization time, and postoperative complications) of the two groups were compared. [Results] There were no cases of conversion to open surgery in the laparoscopic group. Both groups of patients completed the surgery without any unplanned secondary surgery or perioperative deaths. Compared with the open surgery group, the laparoscopic group had a longer operative time, less intraoperative bleeding, and a shorter incision length, with statistically significant differences (P<0.05). The laparoscopic group also had a shorter first postoperative exhaust time and hospitalization time, as well as a lower numerical rating scale (NRS) pain score, compared with the open surgery group, with statistically significant differences(P<0.05). Four patients in the laparoscopic group experienced complications after surgery, including three cases of incision redness, swelling, and exudation, and one case of intestinal obstruction. In the open surgery group, there were 12 patients with complications, including seven instances of incision redness, swelling, and exudation, one case of incision bleeding, three cases of intestinal obstruction, and one case of anastomotic stenosis with incomplete obstruction. The difference in the incidence of complications between the two groups was statistically significant (P<0.05). [Conclusion] Laparoscopic loop ileostomy reversal is a safe, minimally invasive, and feasible surgical method that performs well in reducing postoperative complications and accelerating recovery.