Dataset Information

Impact of a diverting ileostomy in total mesorectal excision with primary anastomosis for rectal cancer.

ABSTRACT:

Background

The role of diverting ileostomy in total mesorectal excision (TME) for rectal cancer with primary anastomosis is debated. The aim of this study is to gain insight in the clinical consequences of a diverting ileostomy, with respect to stoma rate at one year and stoma-related morbidity.

Methods

Patients undergoing TME with primary anastomosis for rectal cancer between 2015 and 2017 in eleven participating hospitals were included. Retrospectively, two groups were compared: patients with or without diverting ileostomy construction during primary surgery. Primary endpoint was stoma rate at one year. Secondary endpoints were severity and rate of anastomotic leakage, overall morbidity rate within thirty days and stoma (reversal) related morbidity.

Results

In 353 out of 595 patients (59.3%) a diverting ileostomy was constructed during primary surgery. Stoma rate at one year was 9.9% in the non-ileostomy group and 18.7% in the ileostomy group (p = 0.003). After correction for confounders, multivariate analysis showed that the construction of a diverting ileostomy during primary surgery was an independent risk factor for stoma at one year (OR 2.563 (95%CI 1.424-4.611), p = 0.002). Anastomotic leakage rate was 17.8% in the non-ileostomy group and 17.2% in the ileostomy group (p = 0.913). Overall 30-days morbidity rate was 37.6% in the non-ileostomy group and 56.1% in the ileostomy group (p < 0.001). Stoma reversal related morbidity rate was 17.9%.

Conclusions

The stoma rate at one year was higher in patients with ileostomy construction during primary surgery. The incidence and severity of anastomotic leakage were not reduced by construction of an ileostomy. The morbidity related to the presence and reversal of a diverting ileostomy was substantial.

SUBMITTER: Hol JC

PROVIDER: S-EPMC10017638 | biostudies-literature | 2023 Mar

REPOSITORIES: biostudies-literature

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Publications

Impact of a diverting ileostomy in total mesorectal excision with primary anastomosis for rectal cancer.

Hol Jeroen C JC Burghgraef Thijs A TA Rutgers Marieke L W MLW Crolla Rogier M P H RMPH van Geloven Anna A W AAW de Jong Gabie M GM Hompes Roel R Leijtens Jeroen W A JWA Polat Fatih F Pronk Apollo A Smits Anke B AB Tuynman Jurriaan B JB Verdaasdonk Emiel G G EGG Consten Esther C J ECJ Sietses Colin C

Surgical endoscopy 20221018 3

<h4>Background</h4>The role of diverting ileostomy in total mesorectal excision (TME) for rectal cancer with primary anastomosis is debated. The aim of this study is to gain insight in the clinical consequences of a diverting ileostomy, with respect to stoma rate at one year and stoma-related morbidity.<h4>Methods</h4>Patients undergoing TME with primary anastomosis for rectal cancer between 2015 and 2017 in eleven participating hospitals were included. Retrospectively, two groups were compared: ...[more]

PMID: 36258000

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Dataset Information

Impact of a diverting ileostomy in total mesorectal excision with primary anastomosis for rectal cancer.

Background

Methods

Results

Conclusions

Publications

Impact of a diverting ileostomy in total mesorectal excision with primary anastomosis for rectal cancer.

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