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Haksal M, Okkabaz N, Atici AE, et al. Fortune of temporary ileostomies in patients treated with laparoscopic low anterior resection for rectal cancer. Ann Surg Treat Res. 2016;92(1):35-41doi: 10.4174/astr.2017.92.1.35.
Haksal, M., Okkabaz, N., Atici, A. E., Civil, O., Ozdenkaya, Y., Erdemir, A., Aksakal, N., & Oncel, M. (2017). Fortune of temporary ileostomies in patients treated with laparoscopic low anterior resection for rectal cancer. Annals of surgical treatment and research, 92(1), 35-41. https://doi.org/10.4174/astr.2017.92.1.35
Haksal, Mustafa, et al. "Fortune of temporary ileostomies in patients treated with laparoscopic low anterior resection for rectal cancer." Annals of surgical treatment and research vol. 92,1 (2017): 35-41. doi: https://doi.org/10.4174/astr.2017.92.1.35
Haksal M, Okkabaz N, Atici AE, Civil O, Ozdenkaya Y, Erdemir A, Aksakal N, Oncel M. Fortune of temporary ileostomies in patients treated with laparoscopic low anterior resection for rectal cancer. Ann Surg Treat Res. 2017 Jan;92(1):35-41. doi: 10.4174/astr.2017.92.1.35. Epub 2016 Dec 30. PMID: 28090504; PMCID: PMC5234425.
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Ann Surg Treat Res. 2017 Jan;92(1):35-41. doi: 10.4174/astr.2017.92.1.35. Epub 2016 Dec 30.

Fortune of temporary ileostomies in patients treated with laparoscopic low anterior resection for rectal cancer.

Annals of surgical treatment and research

Mustafa Haksal, Nuri Okkabaz, Ali Emre Atici, Osman Civil, Yasar Ozdenkaya, Ayhan Erdemir, Nihat Aksakal, Mustafa Oncel

Affiliations

  1. Department of General Surgery, Kartal Education and Research Hospital, Istanbul, Turkey.; Department of General Surgery, Medipol University Medical School, Istanbul, Turkey.
  2. Department of General Surgery, Kartal Education and Research Hospital, Istanbul, Turkey.
  3. Department of General Surgery, Medipol University Medical School, Istanbul, Turkey.

PMID: 28090504 PMCID: PMC5234425 DOI: 10.4174/astr.2017.92.1.35

Abstract

PURPOSE: The current study aims to analyze the risk factors for the failure of ileostomy reversal after laparoscopic low anterior resection for rectal cancer.

METHODS: All patients who underwent a laparoscopic low anterior resection for rectal cancer with a diverting ileostomy between 2007 and 2014 were abstracted. The patients who underwent and did not undergo a diverting ileostomy procedure were compared regarding patient, tumor, treatment related parameters, and survival.

RESULTS: Among 160 (103 males [64.4%], mean [± standard deviation] age was 58.1 ± 11.9 years) patients, stoma reversal was achieved in 136 cases (85%). Anastomotic stricture (n = 13, 52.4%) was the most common reason for stoma reversal. These were the risk factors for the failure of stoma reversal: Male sex (P = 0.035), having complications (P = 0.01), particularly an anastomotic leak (P < 0.001), or surgical site infection (P = 0.019) especially evisceration (P = 0.011), requirement for reoperation (P = 0.003) and longer hospital stay (P = 0.004). Multivariate analysis revealed that male sex (odds ratio [OR], 7.82; P = 0.022) and additional organ resection (OR, 6.71; P = 0.027) were the risk factors. Five-year survival rates were similar (P = 0.143).

CONCLUSION: Fifteen percent of patients cannot receive a stoma reversal after laparoscopic low anterior resection for rectal cancer. Anastomotic stricture is the most common reason for the failure of stoma takedown. Having complications, particularly an anastomotic leak and the necessity of reoperation, limits the stoma closure rate. Male sex and additional organ resection are the risk factors for the failure in multivariate analyses. These patients require a longer hospitalization period, but have similar survival rates as those who receive stoma closure procedure.

Keywords: Ileostomy; Laparoscopy; Rectal neoplasms

Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

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