Table 3 Complications and reoperations in 138 patients related to stoma closure 52 Table 2 Comparison of patient- and surgery-related factors for electively and acutely created stomas in 138 patients a American Society of Anesthesiology Complication Pneumonia Lung embolism Wound infection Urinary tract infection Cellulitis Intraabdominal abscess Anastomotic leakage Small bowel obstruction Dehydration Readmission within 30 days Enterocutaneous fistula Abdominal wall bleeding Jejunal perforation Multi-organ failure Perforation of the primary anastomosis Stenosis of the small bowel anastomosis Total Reoperation Ileostomy Relaparotomy (second look) Evacuation of a hematoma Enterocutaneous fistula closure Debridement Adhesiolysis Stoma revision Total Variables Gender Male Female Age (years) Median (range) ASAa class I II III Primary diagnosis Inflammatory bowel disease Colorectal cancer Familial adenomatous polyposis Other Type of primary surgery Ileal pouch-anal anastomosis Low colorectal anastomosis Time to stoma closure (weeks) Median (range) Number (%) 5 (3.6) 1 (0.7) 2 (1.4) 5 (3.6) 1 (0.7) 3 (2.2) 6 (4.3) 9 (6.5) 3 (2.2) 5 (3.6) 1 (0.7) 1 (0.7) 1 (0.7) 1 (0.7) 1 (0.7) 1 (0.7) 46 complications in 28 (20.3%) patients 8 (5.8%) 4 (2.9%) 1 (0.7%) 1 (0.7%) 1 (0.7%) 1 (0.7%) 1 (0.7%) 17 reoperations in 11 (8.0%) patients Int J Colorectal Dis (2012) 27:49–54 Elective (n=109) Acute (n=29) 65 (59.6) 44 (40.4) 48.5 (19–85) 26 (23.9) 70 (64.2) 13 (11.9) 52 (47.4) 44 (40.4) 4 (3.7) 9 (8.3) 54 (49.5) 55 (50.5) 15 (71.4) 14 (28.6) 48.4 (20–79) 5 (17.2) 20 (69.0) 4 (13.8) 15 (51.7) 7 (24.1) 7 (24.1) – 20 (69.0) 9 (31.0) P value 0.443 0.390 0.745 0.001 0.062 0.004 16.0 (1–71) 22.3 (7–69) higher morbidity after ileostomy closure associated with restorative proctocolectomy in comparison with (low) anterior resection [14]. It has been suggested that extensive dissection and mobilization during restorative proctocolectomy are resulting in adhesion formation [15]. We hypothesized that the traction on the mesentery and its reduced length in the case of an IPAA probably make mobilization and exposure during closure of the ileostomy more difficult. Regarding these observations, it is important to notice that one-stage IPAA is considered a safe procedure in selected patients and comparable to IPAA with a temporary ileostomy with respect to septic complications and pouch function [16]. One-stage IPAA avoids the impaired quality of life, morbidity, and medical costs associated with a defunctioning ileostomy. The present analysis also includes defunctioning ileos- tomies that were created in an acute setting to treat anastomotic-related complications. To our knowledge, there are no other series of ileostomy closure reporting on this specific topic. Closure of the acutely created ileostomies was not associated with increased morbidity in spite of a longer period to stoma closure. Therefore, we would recommend the use of a defunctioning ileostomy for treatment of anastomotic leakage if considered appropriate. The 90% closure rate of our acutely created stomas demonstrates the success rate of this approach. There are some limitations in the interpretation of the provided data. First of all, there are inherent methodological drawbacks because of the retrospective study design, although the complications were prospectively collected. In addition, the group of patients is heterogeneous as patients undergoing (low) anterior resection and proctocolectomies for both benign