A defunctioning stoma in the treatment of lower third rectal carcinoma

Acta chirurgica Belgica
D GiulianiM Vanderveken

Abstract

Total mesorectal excision (TME) is the accepted standard for rectal cancer treatment. However, there is an increased risk of symptomatic anastomotic leakage associated with TME as TME potentially endangers the blood supply of the remaining rectum. On top of this, many patients will receive neo-adjuvant radio-chemotherapy. A defunctioning stoma helps in avoiding severe complications of anastomotic failure. We prospectively collected data of all patients with a rectal carcinoma within reach of the palpating finger, operated on in our department between December 2000 and January 2005. There were 70 patients (42 men and 28 women, median age 70 (range 32-95)). In 40 patients (40/70 = 57%) a sphincter-saving procedure was performed. Eleven patients were diagnosed with anastomotic leakage or failure. Seven patients had neo-adjuvant radio-chemotherapy, 4 had no neo-adjuvant therapy. In 4 patients signs of anastomotic leakage were seen on the barium-enema that is routinely performed before closing the defunctioning stoma. Seven patients (7/40 = 17,5%) had clinical signs of anastomotic leakage. Three of them could be treated conservatively with antibiotics and parenteral nutrition. Two of these patients did not have a defunctioning stoma...Continue Reading

Citations

Jan 30, 2009·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·G PataF Penninckx
May 14, 2010·The Cochrane Database of Systematic Reviews·Alessandro MontedoriIosief Abraha
May 12, 2010·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·F RondelliE Mariani
Aug 31, 2020·The Journal of International Medical Research·Lei NiuXiaomu Zhao
Jan 15, 2019·Journal of the American College of Surgeons·William C ChapmanPaul E Wise

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