Evaluation of the Clinical Outcomes of Colostomy and Subtotal Colectomy in Patients with Paralytic Ileus Associated with Prolonged Hospitalization

Aim: Paralytic ileus secondary to prolonged hospitalization may require surgery in patients unresponsive to conservative management. Colostomy allows rapid decompression, whereas subtotal colectomy offers a more definitive solution; however, comparative evidence remains limited. Methods: We conducted a single-center retrospective study of 13 patients aged ≥65 years hospitalized for≥14 days with paralytic ileus or distension refractory to conservative therapy. Four patients underwent sigmoidostomy, and nine underwent subtotal colectomy. Primary endpoints included mortality and major morbidity, while secondary endpoints encompassed ICU and total hospital stay, time to enteral feeding, need for reoperation, and quality of life. Results: Sigmoidostomy was associated with shorter operative time (65 vs. 160 min, p