Emre Furkan Kırkan, Aylin Acar, Hasan Kumru, Tolga Canbak
Comprehensive Medicine - 2025;17(4):279-285
Objective: This study aimed to evaluate the impact of optimal timing of enterostomy (particularly ileostomy) and colostomy closures on postoperative complications. The goal was to compare early versus late closures to inform surgical strategies and improve patient outcomes. Materials and Methods: Data from 474 patients who underwent ostomy closure between 2008 and 2023 were retrospectively analyzed. Based on prior literature, enterostomy patients were grouped as early (<12 weeks) or late (>12 weeks), and colostomy patients as early (<12 weeks), intermediate (13-20 weeks), or late (>20 weeks). Only patients with complete clinical records were included. Results: Among 366 patients with enterostomy closure, 27.5% (n=101) underwent closure within 12 weeks, while 72.4% (n=265) had closure after 12 weeks. Overall complication rate was 8.4%, with serosal injury (58.1%) and perforation (38.7%) being the most frequent. Late closure was significantly associated with malignant indications (OR = 7.208), preoperative rectoscopy (OR=2.063), and adjuvant therapy (OR=1.735). In 108 patients with colostomy closure, the complication rate was 23.2%, with serosal damage (52.0%) and perforation (40.0%) being most common. Malignancy was less common in patients closed within 12 weeks, but significantly higher in the >20-week group (p<0.001). Malignancy increased the risk of delayed closure by 4.9 times according to logistic regression. Conclusion: Optimal timing of ostomy closure is critical, especially in malignancy-related cases. Delayed closure is linked to increased complication rates. When early closure is applied to selected low-risk patients, outcomes may improve. Surgical timing should be guided by comorbidities, underlying disease, and oncologic treatment history.
