Stoma reversal success rates are generally high, often cited between 80% to 95%, depending on the patient's health, stoma type, and underlying condition, with most studies showing good functional outcomes and patient satisfaction, though rates can be lower for specific complex cases like those following Hartmann's procedure or severe ischemia. Success means a functioning bowel without major complications, but factors like age, other illnesses, and surgical technique influence the outcome.
Colostomy reversal is generally safe, but like any abdominal surgery, it carries risks. The most common risks include: Infection at the wound site. Wound infections are fairly common after reversal because the skin around the stoma already has a lot of natural bacteria.
Generally you will recover quickly following stoma reversal. It is normal to feel weak and tired on discharge home, mainly because your body is recovering from the stress of a general anaesthetic and surgery. However, it is important to allow yourself some time to return to normal activity.
Defunctioning stoma is widely used to reduce anastomotic complications in rectal cancer surgery. However, the complications of stoma and stoma reversal surgery should not be underestimated. Furthermore, in some patients, stoma reversal failed.
The findings demonstrated that early colostomy reversal (performed within 45–120 days) was associated with significantly better outcomes compared to delayed reversal (after 180 days), including lower complication rates, shorter hospital stays, and fewer readmissions and reinterventions.
The reversal is a small operation lasting approximately 30 to 60 minutes but still involves a general anaesthetic. You will usually be in hospital for about three to five days. You will have a small wound where your stoma (ileostomy) was.
Home care
Most people are moderately sore at the reversal site afterwards, but this can be managed with pain killers. You may feel distended following the procedure, some patients describe this as a feeling of being “bruised and bloated” but as the swelling decreases this discomfort will ease.
Stoma reversal surgery has been reported to carry mortality rate of 0.4% to 5%7, 8, 9 and a morbidity rate of almost 50%.
This procedure represents a chance to return to the way life was before ostomy surgery. After your reversal, you'll no longer have to worry about managing an ostomy bag or caring for your stoma, or the various complications that can come with having an ostomy, like leaked fluids and irritated skin.
You will need to fast from midnight on the night before if your surgery is scheduled for the morning, or from 7 am if it is scheduled for the afternoon. No bowel preparation is necessary if you are having reversal of a loop colostomy or ileostomy.
You will probably be in the hospital for three or four days. This surgery is less complicated than the original surgery. After the ostomy-reversal surgery, you will have an open wound on your abdomen where the stoma was. The wound may require packing and wound care for a few weeks after surgery.
While we recommend always checking with your doctor, generally speaking, you're safe to fly around four to six weeks after stoma surgery.
Procedure Details
How Much Does a Colostomy Reversal Cost? On MDsave, the cost of a Colostomy Reversal ranges from $16,115 to $29,350. Those on high deductible health plans or without insurance can shop, compare prices and save. Read more about how MDsave works.
Schreinemacher et al (2011) performed a retrospective cohort study of 150 consecutive patients who underwent stoma reversals over a 4 year period (37). The authors found a hernia prevalence of 32.4% within the cohort.
You may be a good candidate for ostomy reversal surgery if: Your original condition — such as infection, injury, or cancer — has improved or healed completely. Your bowel and rectum have returned to healthy function. You're physically well enough to have surgery.
The optimum time for reversal is between 3 and 12 months following stoma surgery. This is to ensure that you still have good muscle tone and that you bowel is in a good healthy state for surgery.
For many patients living with a temporary colostomy, the possibility of reversal represents hope for returning to their previous way of life. The prospect of resuming normal bowel function and eliminating the need for ostomy care can be a powerful motivator during the challenging adaptation period.
Typically, the diarrhea and increased frequency of bowel movements improve after six months or after your body has had time to retrain itself and regain control over bowel movements. Fecal incontinence is often due to weak anorectal nerves and muscles, as these weren't being used while you had your ostomy.
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How should I sleep after an ileostomy reversal? It's safest to sleep on your back, especially in the days and weeks following the surgery. If you prefer to sleep on your side, avoid putting pressure on the side where your stoma used to be to prevent any discomfort or pressure on that area.
Most studies show that the success rate of ostomy reversal ranges from 80% to 95%, depending on the patient's condition and the type of ostomy. Success is defined as a functioning bowel reconnection without major complications requiring reoperation or a return to a stoma.
Stoma reversal is associated with complications including anastomotic leak, postoperative ileus, bowel obstruction, enterocutaneous fistula, and, most commonly, surgical site infection.
POST SURGICAL INSTRUCTIONS FOR STOMA CLOSURES