O051 - AUTOLOGOUS ILEOSTOMY FILTRATE PREHABILITATION BEFORE ILEOSTOMY CLOSURE IMPROVES NUTRITIONAL AND FUNCTIONAL RECOVERY IN RECTAL CANCER

O051

AUTOLOGOUS ILEOSTOMY FILTRATE PREHABILITATION BEFORE ILEOSTOMY CLOSURE IMPROVES NUTRITIONAL AND FUNCTIONAL RECOVERY IN RECTAL CANCER

Z. Li¹, Y. Zhou^1,*

¹Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, Qingdao, China

Rationale: Diversion of the distal bowel after rectal cancer surgery may worsen nutritional status, colonic conditioning, and low anterior resection syndrome. We evaluated whether autologous ileostomy filtrate prehabilitation improves nutritional and functional recovery before ileostomy closure. 

Methods: In this single-center randomized trial, 154 patients scheduled for ileostomy closure were assigned to 4 weeks of home-based colonic prehabilitation with filtered autologous ileostomy effluent or conventional care. The primary endpoint was the low anterior resection syndrome score at 1, 3, 6, and 12 months.

Results: In the per-protocol cohort, 131 patients were analyzed. Compliance in the intervention group was 95.59%, with no serious intervention-related adverse events. Prehabilitation increased preoperative weight gain (1.96±2.51 vs 0.38±2.39 kg; P<0.001), albumin (44.03±3.79 vs 42.22±4.53 g/L; P=0.014), and total protein (71.26±6.11 vs 67.80±6.69 g/L; P=0.003). Low anterior resection syndrome scores were lower at 1, 3, 6, and 12 months (all P<0.05). Time to first flatus (27.07±9.28 vs 54.65±17.90 h; P<0.001), first defecation (40.35±15.33 vs 69.03±19.03 h; P<0.001), and hospital stay (4.74±2.86 vs 5.84±3.29 days; P=0.042) were reduced.

Conclusion: Autologous ileostomy filtrate prehabilitation was safe, feasible, and associated with better preoperative nutritional status, less severe bowel dysfunction, and faster recovery after ileostomy closure.

Disclosure of Interest: None declared