Stoma reversals following open abdomen management: A retrospective study from Eastern India

Background: Stoma creation during open abdomen (OA) management is often necessary to reduce sepsis and protect anastomoses. However, there is no evidence on reversal timing and outcomes in this high-risk group. Aims and Objectives: To evaluate stoma-related complications, reversal timing, operative outcomes, and post-reversal morbidity in patients who underwent stoma formation during OA management. Materials and Methods: We conducted a retrospective analysis of 32 patients who underwent stoma reversal following OA management between May 2022 and April 2025, with follow-up until June 2025. Patient demographics, nutritional parameters, comorbidities, stoma type, interval to reversal, and intra- and post-operative outcomes were analysed. Statistical comparisons were performed using the Mann–Whitney U and Fisher’s exact tests with Bonferroni correction by the Statistical Package for Social Sciences version 26 (IBM, NY, USA). Results: Of 32 patients, 6 had jejunostomies, 17 had ileostomies, and 9 had colostomies. Colostomy patients were older (mean 59.9 years) than ileostomy (55.8 years) and jejunostomy (50.8 years). Jejunostomy patients had poorer nutritional parameters. Median wait times were significantly shorter for jejunostomy compared with ileostomy (P=0.0142) and colostomy (P=0.0015). Ileostomy reversals had the shortest operative times (85 min vs. 117.5 min for jejunostomy, P=0.0117; 150 min for colostomy, P=0.0006). Stoma-related complications were most frequent in jejunostomy (83%), compared with ileostomy (29%) and colostomy (22%) (P=0.024). Post-reversal complications occurred in 66.7% of jejunostomy, 41.2% of ileostomy, and 44.4% of colostomy patients, respectively. One mortality occurred in the jejunostomy group due to hypokalemia. Conclusion: Jejunostomy patients experienced the highest morbidity requiring earlier reversal. Ileostomy reversals had shorter operative times and lower complication rates. Colostomies had the longest wait time and demonstrated broader post-operative morbidity. Stoma reversal following OA management requires balancing early closure to prevent ongoing stoma-related morbidity against delayed reversal to minimize risks from adhesions and sepsis. Larger prospective studies are required to optimize reversal timing and improve outcomes.