2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T63d,Strategies to optimise bowel function before stoma reversal surgery (SRS) are needed to improve postoperative outcomes. Efferent bowel stimulation (EBS) prior to stoma closure has been proposed as a potential strategy to reduce postoperative ileus (POI) incidence and improve the patient's postoperative course. A multicentre randomised controlled trial was designed to evaluate the effectiveness of pre-SRS EBS in reducing POI incidence. Patients scheduled for elective SRS were randomised 1:1 to either an intervention group, receiving daily EBS with saline and a nutritional thickener for 2 weeks preoperatively, or a control group, undergoing SRS without stimulation. The primary endpoint was POI incidence. Secondary outcomes included the time to oral diet tolerance, passage of first flatus/stool, surgery-related comorbidities, length of hospital stay and incidence of Low Anterior Resection Syndrome (LARS) (NCT05302557-31/03/2022). From June 2021 to April 2023, 175 patients were enrolled from 18 hospitals in Spain, 78 (44.5%) and 97 (55.4%) of whom were allocated to the intervention and control groups, respectively. We found that EBS was not significantly associated with a decrease in POI incidence (7.6% vs. 16.4%, p = 0.088). No significant differences in the median hospital stay (p = 0.545) or LARS at discharge (p = 0.087) were observed between the two groups. The EBS group showed fewer but more severe complications (p = 0.015). Preoperative EBS is a feasible and reproducible intervention that may represent a potential strategy to reduce POI following SRS.31:Ta0e,Abstract Background Strategies to optimise bowel function before stoma reversal surgery (SRS) are needed to improve postoperative outcomes. Efferent bowel stimulation (EBS) prior to stoma closure has been proposed as a potential strategy to reduce postoperative ileus (POI) incidence and improve the patient's postoperative course. Methods A multicentre randomised controlled trial was designed to evaluate the effectiveness of pre‐SRS EBS in reducing POI incidence. Patients scheduled for elective SRS were randomised 1:1 to either an intervention group, receiving daily EBS with saline and a nutritional thickener for 2 weeks preoperatively, or a control group, undergoing SRS without stimulation. The primary endpoint was POI incidence. Secondary outcomes included the time to oral diet tolerance, passage of first flatus/stool, surgery‐related comorbidities, length of hospital stay and incidence of Low Anterior Resection Syndrome (LARS) (NCT05302557‐31/03/2022). Results From June 2021 to April 2023, 175 patients were enrolled from 18 hospitals in Spain, 78 (44.5%) and 97 (55.4%) of whom were allocated to the intervention and control groups, respectively. We found that EBS was not significantly associated with a decrease in POI incidence (7.6% vs. 16.4%, p = 0.088). No significant differences in the median hospital stay ( p = 0.545) or LARS at discharge ( p = 0.087) were observed between the two groups. The EBS group showed fewer but more severe complications ( p = 0.015). Conclusion Preoperative EBS is a feasible and reproducible intervention that may represent a potential strategy to reduce POI following SRS. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Loop Ileostomy: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Loop Ileostomy (condition). Clinician-written summaries and actionable practice insights. 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We found that EBS was not significantly associated with a decrease in POI incidence (7.6% vs. 16.4%, p = 0.088). No significant differences in the median hospital stay (p = 0.545) or LARS at discharge (p = 0.087) were observed between the two groups. The EBS group showed fewer but more severe complications (p = 0.015).","abstract":"$30","keywords":["bowel stimulation","ileostomy reversal","loop ileostomy closure","postoperative ileus"],"pubmed_id":"42092745","conclusions":"Preoperative EBS is a feasible and reproducible intervention that may represent a potential strategy to reduce POI following 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Syndrome","value_numeric":null},{"paper_doi":"10.1111/codi.70448","tag_type":"condition","value":"Postoperative Ileus","value_numeric":null},{"paper_doi":"10.1111/codi.70448","tag_type":"condition","value":"Rectal Cancer","value_numeric":null},{"paper_doi":"10.1111/codi.70448","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1111/codi.70448","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1111/codi.70448","tag_type":"modality","value":"Efferent Bowel Stimulation","value_numeric":null},{"paper_doi":"10.1111/codi.70448","tag_type":"sample_size","value":"n=175","value_numeric":175},{"paper_doi":"10.1111/codi.70448","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/codi.70448","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1111/codi.70448","tag_type":"warning","value":"LARS outcomes were assessed at discharge and 1 and 6 months but the 6-month follow-up data may be incomplete for patients enrolled late in the study period.","value_numeric":null},{"paper_doi":"10.1111/codi.70448","tag_type":"warning","value":"The higher rate of major complications (CD ≥3) in the EBS group, including one death, is a safety signal, though authors attributed these to patient- and surgery-related factors rather than EBS itself — causality cannot be fully excluded.","value_numeric":null},{"paper_doi":"10.1111/codi.70448","tag_type":"warning","value":"The trial was likely underpowered: the assumed control POI rate (29%) was nearly double the observed rate (16.4%), which may explain the failure to reach statistical significance despite a clinically meaningful effect size.","value_numeric":null},{"paper_doi":"10.1111/codi.70448","tag_type":"warning","value":"Unequal group allocation (78 vs. 97) despite 1:1 randomisation suggests possible block randomisation issues, as acknowledged by the authors.","value_numeric":null}],"summaries":{"what_studied":"The ILEOSTIM trial evaluated whether 2-week preoperative efferent bowel stimulation (EBS) — daily irrigation of 500 mL saline plus a nutritional thickener — reduced postoperative ileus (POI) after ileostomy reversal, compared to surgery alone, in adult rectal cancer patients across 18 Spanish hospitals (June 2021–April 2023).","key_result":"POI occurred in 7.6% of the EBS group vs. 16.4% of controls (p = 0.088); adjusted analysis showed 53% lower odds of POI with EBS (OR 0.47, 95% CI 0.17–1.29), but this did not reach statistical significance. Median hospital stay was 4 days in both groups. The EBS group had fewer overall complications (34.6% vs. 39.2%) but more major complications (CD ≥3: 9.0% vs. 1.0%, p = 0.015), including one death.","limitations":"- The study was underpowered relative to its observed effect (target assumed 29% POI rate in controls; actual rate was 16.4%), and unequal group sizes suggest randomisation imbalance.\n- Baseline differences favored worse outcomes in the EBS group (longer primary surgery, more prior major complications, longer interval to reversal), potentially masking a true benefit.\n- Protocol adherence to EBS was not formally measured, risking underestimation of the true effect.","practice_takeaway":"Preoperative efferent bowel stimulation before ileostomy reversal is feasible and safe to deliver in an outpatient setting, and may halve the risk of POI, but current evidence does not yet support routine use — a larger, adequately powered trial with stratified randomisation is warranted. Clinicians should note the signal of more severe complications in the EBS group, though these were not attributed directly to the intervention."}}],"initialOffset":1,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"condition","value":"Loop Ileostomy"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Conditions","href":"/hub/tag/condition"},{"name":"Loop Ileostomy"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"condition","hub_tag_value":"Loop Ileostomy"}}}]]

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