Anastomotic leak after restorative proctosigmoidectomy for cancer: what are the chances of a permanent ostomy?

International Journal of Colorectal Disease
James W OgilvieLuca Stocchi

Abstract

The objective of this study is to identify rates and factors associated with permanent diversion following restorative proctosigmoidectomy for rectal cancer when complicated by an anastomotic leak. This study is a retrospective review. The setting of this study is a tertiary referral hospital Patients involved in this study were those who underwent restorative rectal cancer surgery from 1997 through 2008 identified from an institutional cancer database. No interventions were performed in this study. Factors associated with time to ostomy closure and rates of permanent diversion following anastomotic leaks One hundred and thirty patients (mean age 59.7 years) were identified, 111 (85%) of whom had stoma diversion at the index surgery. Asymptomatic occult radiological leaks occurred in 52 patients (40%). Seventy-eight patients (60%) underwent ultimate ostomy closure at a median time of 6.3 months after the index surgery, which was not significantly affected by previous radiotherapy (p = 0.08). Twelve patients (9%) underwent anastomotic reconstruction. Pathologic stage II or greater (OR 4.42; 1.95-10.04), symptomatic presentation (OR 4.13; 1.86-9.19) and anastomotic disruption >5 mm (OR 4.42; 2.01-9.74) were independently associat...Continue Reading

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Citations

May 22, 2013·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Benjamin D ShoganKonstantin Umanskiy
Aug 9, 2016·Current Problems in Surgery·Monika A KrezalekJohn C Alverdy
Sep 17, 2016·Journal of Wound, Ostomy, and Continence Nursing : Official Publication of the Wound, Ostomy and Continence Nurses Society·Xi SuHuizhen Wang
Jun 18, 2017·World Journal of Surgery·Joanna Chung Kiu MakWai Lun Law
Apr 11, 2018·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Kinga B SkowronNeil H Hyman

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