BACKGROUND AND AIMS: This study assessed the timing of reversal of defunctioning stoma following low anterior resection of the rectum for cancer and risk factors for a defunctioning stoma becoming permanent in patients who were not reversed. MATERIAL AND METHODS: Patients who underwent low anterior resection with defunctioning stoma during a 12-year period were assessed with regard to timing of stoma reversal. Delayed reversal was defined as >4 months after low anterior resection. Patients with a defunctioning stoma that was never reversed were assessed regarding risk factors for permanent stoma. RESULTS: A total of 134 patients were analyzed. Of 106 stoma reversals, 19% were reversed within 4 months of low anterior resection, while 81% were reversed later than 4 months. In 58% of these patients, the delay was to due to low medical priority given to this procedure. The other main reasons for delayed stoma reversal were nonsurgical complications (20%), symptomatic anastomotic leakage following low anterior resection (12%), and postoperative adjuvant chemotherapy (10%). Of all patients, 21% (28/134) ended up with a permanent stoma. Risk factors for a defunctioning stoma becoming permanent were stage IV cancer (P < 0.001) and symptomatic anastomotic leakage following low anterior resection (P < 0.001). CONCLUSION: Four in five patients experienced a delayed stoma reversal, in a majority because of the low priority given to this surgical procedure.
BACKGROUND AND AIMS: This study assessed the timing of reversal of defunctioning stoma following low anterior resection of the rectum for cancer and risk factors for a defunctioning stoma becoming permanent in patients who were not reversed. MATERIAL AND METHODS:Patients who underwent low anterior resection with defunctioning stoma during a 12-year period were assessed with regard to timing of stoma reversal. Delayed reversal was defined as >4 months after low anterior resection. Patients with a defunctioning stoma that was never reversed were assessed regarding risk factors for permanent stoma. RESULTS: A total of 134 patients were analyzed. Of 106 stoma reversals, 19% were reversed within 4 months of low anterior resection, while 81% were reversed later than 4 months. In 58% of these patients, the delay was to due to low medical priority given to this procedure. The other main reasons for delayed stoma reversal were nonsurgical complications (20%), symptomatic anastomotic leakage following low anterior resection (12%), and postoperative adjuvant chemotherapy (10%). Of all patients, 21% (28/134) ended up with a permanent stoma. Risk factors for a defunctioning stoma becoming permanent were stage IV cancer (P < 0.001) and symptomatic anastomotic leakage following low anterior resection (P < 0.001). CONCLUSION: Four in five patients experienced a delayed stoma reversal, in a majority because of the low priority given to this surgical procedure.
Entities:
Keywords:
Rectal cancer; defunctioning stoma; low anterior resection of the rectum; permanent stoma; risk factors; stoma reversal; temporary stoma
Authors: Heleen S Snijders; Nicoline J van Leersum; Daan Henneman; Alexander C de Vries; Rob A E M Tollenaar; Anne M Stiggelbout; Michel W J M Wouters; Jan Willem T Dekker Journal: Ann Surg Oncol Date: 2015-02-18 Impact factor: 5.344
Authors: Zbigniew Banaszkiewicz; Łukasz P Woda; Tomasz Zwoliński; Krzysztof Tojek; Paweł Jarmocik; Arkadiusz Jawień Journal: Prz Gastroenterol Date: 2015-02-13
Authors: Mustafa Haksal; Nuri Okkabaz; Ali Emre Atici; Osman Civil; Yasar Ozdenkaya; Ayhan Erdemir; Nihat Aksakal; Mustafa Oncel Journal: Ann Surg Treat Res Date: 2016-12-30 Impact factor: 1.859