Primary Repair versus Loop Ileostomy in Typhoid Ileal Perforation: Evaluation of Early Postoperative Outcomes

Abstract

Background: Operation for typhoid ileal perforation is frequently performed in different units of surgery of Mymensingh Medical College and hospital, Mymensingh, Bangladesh. This study was conducted to compare the results of two different techniques that is primary repair and loop ileostomy used for the management of typhoid ileal perforation regarding early postoperative outcomes. Methods and Materials: This was a prospective comparative study conducted from July 2020 to December 2021 in the Department of Surgery, Mymensingh Medical College Hospital, Mymensingh, Bangladesh. All the patients were divided into two groups; group-A: Patients who underwent primary repair of ileal perforation and group-B: Patients who underwent loop ileostomy. A p value <0.05 was considered statistically significant. Results: The study was conducted on 80 patients who were diagnosed as a case of typhoid ileal perforation who were admitted in different units of surgery of Mymensingh Medical College Hospital. Each group consisted of 40 patients. The mean age was 37.4±8.66 years and 37.02+9.68 years in Group A and Group B respectively. In our study, overall 37.5% and 60.0% incidence of complications were found in primary repair and loop ileostomy group respectively which was statistically significant (P=0.025). It was observed that 16(40.0%) patient developed ileostomy specific complications, among them skin excoriation was the commonest. A statistically significant difference was noted between mean duration of hospital stay of both groups (8.45±2.93 days vs 6.70±1.54 days ;p<0.05). Average hospital cost was significantly lower in Group A compare to Group B (p<0.001) Conclusion: Primary repair is a better choice for management of typhoid ileal perforation in compared to loop ileostomy in single site, early hospitalized patient because it is a one stage procedure with less complication.