OBJECTIVE: A temporary loop ileostomy is often created to minimize the impact of peritoneal sepsis from an anastomotic dehiscence following colo-anal or low colorectal anastomosis. These stomas are not without complications. Clinicians tend to advise patients that their loop ileostomy will be reversed within 6-12 weeks of formation. However, factors such as adjuvant chemotherapy may affect the timing of closure. The aim of this study was to review the time between formation and closure of loop ileostomies following total mesorectal excision in patients with rectal cancer. METHOD: A retrospective study of 50 patients with loop ileostomies to defunction total mesorectal excisions for rectal cancer, between April 2002 and July 2005. RESULTS: Of the 50 patients with defunctioning loop ileostomies, 24 received adjuvant chemo-radiotherapy, and 26 did not. There was a 28% morbidity. The overall median time from formation to closure was 142 days (35-575). Median time from formation to closure in those with adjuvant therapy was 197 days (35-575) and in those with no adjuvant therapy was 133 days (75-395). This was a significant delay (P = 0.049). Sixteen stomas were not closed to date. CONCLUSION: Time between formation and closure of loop ileostomy following anterior resection of rectum is significantly delayed by adjuvant chemotherapy. Because of their high morbidity, defunctioning ileostomies should be closed as early as medically possible, especially if adjuvant chemotherapy is planned.
OBJECTIVE: A temporary loop ileostomy is often created to minimize the impact of peritoneal sepsis from an anastomotic dehiscence following colo-anal or low colorectal anastomosis. These stomas are not without complications. Clinicians tend to advise patients that their loop ileostomy will be reversed within 6-12 weeks of formation. However, factors such as adjuvant chemotherapy may affect the timing of closure. The aim of this study was to review the time between formation and closure of loop ileostomies following total mesorectal excision in patients with rectal cancer. METHOD: A retrospective study of 50 patients with loop ileostomies to defunction total mesorectal excisions for rectal cancer, between April 2002 and July 2005. RESULTS: Of the 50 patients with defunctioning loop ileostomies, 24 received adjuvant chemo-radiotherapy, and 26 did not. There was a 28% morbidity. The overall median time from formation to closure was 142 days (35-575). Median time from formation to closure in those with adjuvant therapy was 197 days (35-575) and in those with no adjuvant therapy was 133 days (75-395). This was a significant delay (P = 0.049). Sixteen stomas were not closed to date. CONCLUSION: Time between formation and closure of loop ileostomy following anterior resection of rectum is significantly delayed by adjuvant chemotherapy. Because of their high morbidity, defunctioning ileostomies should be closed as early as medically possible, especially if adjuvant chemotherapy is planned.
Authors: Christopher M Dodgion; Bridget A Neville; Stuart R Lipsitz; Yue-Yung Hu; Deborah Schrag; Elizabeth Breen; Caprice C Greenberg Journal: J Surg Res Date: 2012-12-21 Impact factor: 2.192
Authors: Mauro Podda; Patricia Sylla; Gianluca Baiocchi; Michel Adamina; Vanni Agnoletti; Ferdinando Agresta; Luca Ansaloni; Alberto Arezzo; Nicola Avenia; Walter Biffl; Antonio Biondi; Simona Bui; Fabio C Campanile; Paolo Carcoforo; Claudia Commisso; Antonio Crucitti; Nicola De'Angelis; Gian Luigi De'Angelis; Massimo De Filippo; Belinda De Simone; Salomone Di Saverio; Giorgio Ercolani; Gustavo P Fraga; Francesco Gabrielli; Federica Gaiani; Mario Guerrieri; Angelo Guttadauro; Yoram Kluger; Ari K Leppaniemi; Andrea Loffredo; Tiziana Meschi; Ernest E Moore; Monica Ortenzi; Francesco Pata; Dario Parini; Adolfo Pisanu; Gilberto Poggioli; Andrea Polistena; Alessandro Puzziello; Fabio Rondelli; Massimo Sartelli; Neil Smart; Michael E Sugrue; Patricia Tejedor; Marco Vacante; Federico Coccolini; Justin Davies; Fausto Catena Journal: World J Emerg Surg Date: 2021-07-02 Impact factor: 5.469
Authors: Magdalena Pisarska; Natalia Gajewska; Piotr Małczak; Michał Wysocki; Jan Witowski; Grzegorz Torbicz; Piotr Major; Magdalena Mizera; Marcin Dembiński; Marcin Migaczewski; Andrzej Budzyński; Michał Pędziwiatr Journal: Oncotarget Date: 2018-04-17