Reversal of defunctioning stoma following rectal cancer surgery: are we getting better? A population-based single centre experience

ANZ Journal of Surgery
Soran GadanPeter Matthiessen

Abstract

The aim was to assess factors influencing the timing of defunctioning stoma (DS) reversal following low anterior resection of rectum for cancer (LAR). All patients operated with LAR and a primary DS during a 9-year period were included. Reversal later than 120 days after LAR was considered as delayed. A DS not reversed within 2 years was considered as permanent. In the present study, median age at LAR was 67 years, 45% were females, median body mass index was 25, 87% had American Society of Anesthesiologists class I or II, 64% had pre-operative radiotherapy, and 3% had cancer stage IV. A total of 79% (92/116) underwent stoma reversal, whereof 25% (23/92) were reversed within 120 days. The most common health-related reasons for delayed stoma reversal were adjuvant chemotherapy in 38%, symptomatic anastomotic leakage in 16% and other post-operative adverse events in 13%. In 35% delayed stoma reversal was because of low priority within the healthcare system. A total of 18% (20/110) never had their DS reversed (n = 11) or had their DS converted to a permanent end colostomy (n = 9). Major risk factors for permanent stoma were stage IV cancer in 55%, and symptomatic anastomotic leakage in 30%. One fourth of the patients had their def...Continue Reading

References

Aug 10, 2006·Diseases of the Colon and Rectum·Rodrigo Oliva PerezJoaquim Gama-Rodrigues
May 17, 2007·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·J T LordanD P Edwards
Jan 4, 2008·Diseases of the Colon and Rectum·Akira TsunodaMitsuo Kusano
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Apr 10, 2009·The British Journal of Surgery·W S TanK W Eu
Jan 10, 2012·Diseases of the Colon and Rectum·Evangelos MessarisLisa S Poritz
May 12, 2012·International Journal of Colorectal Disease·Oscar ÅkessonPamela Buchwald
Sep 24, 2013·Scandinavian Journal of Surgery : SJS : Official Organ for the Finnish Surgical Society and the Scandinavian Surgical Society·H FloodeenP Matthiessen
Sep 24, 2015·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·Bertrand CelerierEric Rullier
Jan 11, 2017·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·H FloodeenP Matthiessen
May 2, 2017·The Journal of Surgical Research·Linda LiDaniel A Anaya
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Aug 19, 2017·Techniques in Coloproctology·W LiE Gorgun

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Citations

Apr 15, 2021·Langenbeck's Archives of Surgery·Susana OurôRui Maio
Jul 27, 2021·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·Klas HolmgrenMartin Rutegård
Jul 6, 2021·Scandinavian Journal of Gastroenterology·Kevin AfshariAbbas Chabok

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