AI Article Synopsis
- Temporary diverting ileostomy is used after rectal cancer surgery to prevent complications from anastomotic leakage, but it carries risks of high morbidity and some mortality.
- A study of 96 patients from 2001 to 2012 found that while the ileostomy was in place, morbidity and mortality rates were 21% and 1%, respectively; 86 patients had their stomas closed with no postoperative deaths and a 24% morbidity rate.
- Adjuvant chemotherapy was linked to a longer recovery time for bowel continuity, but it did not affect the overall complication rate.
Article Abstract
Introduction: A temporary diverting ileostomy is frequently used to reduce the consequences of a distal anastomotic leakage after total mesorectal excision in rectal cancer surgery. This surgical technique is associated with high morbidity and a not negligible mortality. The aim of this study is to evaluate the morbidity and mortality rate associated with an ileostomy and its posterior closure.
Material And Methods: Between 2001 and 2012, 96 patients with temporary diverting ileostomy were retrospectively analyzed. Morbidity and mortality were analyzed before and after the stoma closure. The studied variables included age, sex, comorbidities, time to bowel continuity restoration and adjuvant chemotherapy.
Results: In 5 patients the stoma was permanent and another 5 died. The morbidity and mortality rates associated with the stoma while it was present were 21 and 1% respectively. We performed a stoma closure in 86 patients, 57% of whom had previously received adjuvant therapy. There was no postoperative mortality after closure and the morbidity rate was 24%. The average time between initial surgery and restoration of intestinal continuity was 152.2 days. This interval was significantly higher in patients who had received adjuvant therapy. No statistically significant difference was found between the variables analyzed and complications.
Conclusions: Diverting ileostomy is associated with low mortality and high morbidity rates before and after closure. Adjuvant chemotherapy significantly delays bowel continuity restoration, although in this study did not influence in the rate of complications.
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| http://dx.doi.org/10.1016/j.ciresp.2013.12.011 | DOI Listing |
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