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Beverly Hills · 435 N. Bedford Dr., Suite 308Mon–Fri 9:00 am – 5:00 pmMost PPO insurance accepted
Allen KamravaMD · MBA · FACS · FASCRS

Procedure

Diverting Loop Ileostomy Creation / Closure

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Back to work
2-4 weeks (after creation), 2-4 weeks (after closure)
Success rate
Greater than 95% (for successful diversion)
Recurrence
N/A

What it is

What is a Diverting Loop Ileostomy?

A diverting loop ileostomy is a temporary stoma created to divert the fecal stream away from a downstream anastomosis, allowing it to heal without being exposed to stool. It is commonly performed after a low anterior resection for rectal cancer or an ileal pouch-anal anastomosis (IPAA) for ulcerative colitis. The procedure involves bringing a loop of the small intestine (ileum) through the abdominal wall and creating an opening. The stoma has two openings: a proximal opening that diverts stool into an ostomy bag, and a distal opening that leads to the downstream anastomosis. The stoma is typically reversed in a second, smaller operation after 2-3 months.

Am I a candidate?

Who is a Good Candidate for a Diverting Loop Ileostomy?

A diverting loop ileostomy is typically performed in patients who have undergone a low colorectal or coloanal anastomosis, or an ileal pouch-anal anastomosis, particularly in the setting of neoadjuvant radiation, poor nutritional status, or other risk factors for anastomotic leak. It is also used to protect a technically difficult anastomosis or to manage a contained anastomotic leak.

Recovery

What is the Recovery Like?

Recovery after the creation of a diverting loop ileostomy involves a hospital stay of 3-7 days. Patients are taught how to care for their stoma by a specialized stoma nurse. The stoma closure operation is a smaller procedure, typically requiring a hospital stay of 2-4 days. After closure, patients can expect a gradual return to their normal bowel function over several weeks.

Risks & considerations

What are the Risks?

While a diverting loop ileostomy is a common and relatively safe procedure, it is associated with several potential risks, including:

  • Dehydration and Electrolyte Imbalance: High stoma output can lead to significant fluid and electrolyte losses.
  • Stoma-Related Complications: These include skin irritation, retraction, prolapse, or hernia.
  • Small Bowel Obstruction: Adhesions or a twist at the stoma site can lead to a blockage.
  • Complications of Closure: The stoma closure operation carries its own risks, including wound infection, anastomotic leak, and bowel obstruction.

Sources

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