Title: A Comparative Study between the Outcome of Primary Repair Versus Ileostomy in Ileal Perforation: Our Institutional Experience
Authors: Dr T.V.S.S. Naga Babu, Dr Reddy Harika, Dr D.S. Chakravarthy, Dr Suvarchala Akkidas
DOI: https://dx.doi.org/10.18535/jmscr/v7i9.57
Abstract
Background: In emergency surgery, ileal perforation is commonly encountered. Management of ileal perforation can be either by primary repair or ileostomy. The decision regarding repair or stoma is controversial. Therefore, in this study we reviewed our instituitional experience regarding the ideal management of ileal perforation and its associated morbidity.
Aims and Objectives: To study the management of ileal perforation and to evaluate and compare the outcome of primary repair and ileostomy in ileal perforation with respect to the preoperative parameters, post operative complications and mortality and also to find the ideal procedure.
Methods: This is a prospective comparative study done from June 2017 to May 2019. 30 cases with ileal perforation were included. Informed consent was taken. Patients were divided into two groups, group A and group B namely. Group A underwent primary repair and group B underwent ileostomy. All patients between 18years to 75 years presenting with ileal perforation were included in the study. Emergency cases other than ileal perforation were excluded.
Results: The most common age group involved was 46-60 years. There were 24 males and 6 females. Out of 30 patients of the study, 14 patients underwent primary repair and 16 patients underwent ileostomy. Most common complication is leak in primary repair. Stoma related complications occurred in 2 cases. Mortality rate was higher in primary repair group in this study.
Conclusion: Despite of various procedures, mortality and morbidity is high in emergency bowel surgery. Over all, the main determine to do primary repair or ileostomy is the general condition of the patient.
Keywords: Primary repair, stoma, diversion, ileal perforation, ileostomy.
