BACKGROUND: The use of protective stoma in anterior resection (AR) is controversial. Neoadjuvant therapy, TME and laparoscopy seem to increase the rate of anastomotic dehiscences (a.d.). PATIENTS AND METHODS: In a prospective study, 219 patients were submitted to elective open AR (109 patients), open AR+TME nerve-sparing (110 patients), 35 of which had intrasphinteric anastomosis. Fifty-five patients were treated by neoadjuvant therapy. Primary stoma was not performed. RESULTS: We had 15 (6.8%) a.d.: 5 (2.3%) major and 10 (4.4%) minor. In the five major a.d. an immediate colostomy was performed with one death. In the 10 minor the a.d. was cured conservatively. CONCLUSIONS: A protective stoma is necessary in less than 10% of the patients treated with AR, so avoiding further surgery, mortality, morbidity and higher medical costs in most patients.
BACKGROUND: The use of protective stoma in anterior resection (AR) is controversial. Neoadjuvant therapy, TME and laparoscopy seem to increase the rate of anastomotic dehiscences (a.d.). PATIENTS AND METHODS: In a prospective study, 219 patients were submitted to elective open AR (109 patients), open AR+TME nerve-sparing (110 patients), 35 of which had intrasphinteric anastomosis. Fifty-five patients were treated by neoadjuvant therapy. Primary stoma was not performed. RESULTS: We had 15 (6.8%) a.d.: 5 (2.3%) major and 10 (4.4%) minor. In the five major a.d. an immediate colostomy was performed with one death. In the 10 minor the a.d. was cured conservatively. CONCLUSIONS: A protective stoma is necessary in less than 10% of the patients treated with AR, so avoiding further surgery, mortality, morbidity and higher medical costs in most patients.
Authors: Kevin B Wise; Amit Merchea; Robert R Cima; Dorin T Colibaseanu; Kristine M Thomsen; Elizabeth B Habermann Journal: J Gastrointest Surg Date: 2014-11-22 Impact factor: 3.452
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