Is the Use of a Support Bridge Beneficial for Preventing Stomal Retraction After Loop Ileostomy? A Prospective Nonrandomized Study

PURPOSE: A temporary defunctioning loop ileostomy is frequently created during low colorectal or coloanal anastomosis to prevent peritoneal sepsis associated with anastomotic leakage. We investigated whether routine support bridge placement prevents stoma retraction after the formation of a loop ileostomy. DESIGN: Prospective, nonrandomized trial. SUBJECTS AND SETTING: The study sample comprised 32 consecutive patients who underwent defunctioning loop ileostomy at an academic tertiary care center in Seoul Korea from February to September 2010. METHODS: Patients were nonrandomly allocated to no bridge, short-term bridge (1 week), and long-term bridge (3 weeks) groups based on the surgeon's clinical judgment. Group differences in stoma height changes over time were analyzed. RESULTS: Subjects' mean age was 59.5 (range: 43-82) years, and the male-to-female ratio was 2.2:1.0. The mean heights of the stoma on postoperative day 2 and postoperative month 3, respectively, were 1.07 0.16 cm (mean +/- SD) and 0.81 +/- 0.17 cm in the no-bridge group, 1.70 +/- 0.29 cm and 1.21 +/- 0.18 cm in the short-term bridge group, and 1.18 +/- 0.16 cm and 1.01 +/- 0.20 cm in the long-term bridge group. The changes in the stoma height 3 months after the surgery showed no statistically significant differences among the groups (P = .430). Stoma Quality of Life scores at 3 weeks (47.4 vs 46.1; P = .730) were similar for patients with and without bridges. However, a significantly greater number of patients with bridges reported difficulty with pouch changes compared to those without bridges (72.7% vs 14.3%; P = .002). CONCLUSIONS: Routine use of support bridges during loop ileostomy is unnecessary and inconvenient to patients. If a support bridge must be used, it can be removed early.