Objective: The objective was to study morbidity and mortality associated with early closure (8-13 days) of a temporary stoma compared with standard procedure (closure after > 12 weeks) after rectal resection for cancer.
Background: A temporary ileostomy may reduce the risk of pelvic sepsis after anastomotic dehiscence. However, the temporary ileostomy is afflicted with complications and requires a second surgical procedure (closure) with its own complications. Early closure of the temporary ileostomy could reduce complications for rectal cancer patients.
Methods: Early closure (8-13 days after stoma creation) of a temporary ileostomy was compared with late closure (>12 weeks) in a multicenter randomized controlled trial, EASY (www.clinicaltrials.gov, NCT01287637) including patients undergoing rectal resection for cancer. Patients with a temporary ileostomy without signs of postoperative complications were randomized to closure at 8 to 13 days or late closure (>12 weeks after index surgery). Clinical data were collected up to 12 months. Complications were registered according to the Clavien-Dindo Classification of Surgical Complications, and Comprehensive Complication Index was calculated.
Results: The trial included 127 patients in eight Danish and Swedish surgical departments, and 112 patients were available for analysis. The mean number of complications after index surgery up to 12 months follow up was significantly lower in the intervention group (1.2) compared with the control group (2.9), P < 0.0001.
Conclusions: It is safe to close a temporary ileostomy 8 to 13 days after rectal resection and anastomosis for rectal cancer in selected patients without clinical or radiological signs of anastomotic leakage.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/SLA.0000000000001829 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Postoperative unexplained sigmoid stenosis in a patient with rectal cancer complicated with connective tissue disease: a case report and literature review.
Front Oncol
December 2024
Department of General Surgery, General Hospital of Northern Theater Command, Shenyang, China.
It is well established that host immunity plays a critical role in defending against colorectal cancer (CRC) progression. Connective tissue disease (CTD) encompasses a group of heterogeneous, immune-mediated disorders that present with diverse and often non-specific initial symptoms. Raynaud's phenomenon is a common feature, complicating early diagnosis.
View Article and Find Full Text PDFRisk factors for anastomotic complications after elective intestinal resection in Crohn's disease.
Turk J Surg
June 2024
Department of General Surgery, Marmara University Faculty of Medicine, İstanbul, Türkiye.
Objectives: Anastomotic leaks are the most feared complications after surgery in patients with Crohn's disease. Identifying associated risk factors is crucial for prevention. We aimed to evaluate possible risk factors for anastomotic complications in our case series.
View Article and Find Full Text PDFImage-based deep learning model to predict stoma-site incisional hernia in patients with temporary ileostomy: A retrospective study.
iScience
November 2024
Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, P.R. China.
The prophylactic implantation of biological mesh can effectively prevent the occurrence of stoma-site incisional hernia (SSIH) in patients undergoing stoma retraction. Therefore, our study prospectively established and validated a mixed model, which combined radiomics, stepwise regression, and deep learning for the prediction of SSIH in patients with temporary ileostomy. The mixed model showed good discrimination of the SSIH patients on all cohorts, which outperformed deep learning, radiomics, and clinical models alone (overall area under the curve [AUC]: 0.
View Article and Find Full Text PDFTemporary loop end ileostomy reduces the risk of stoma outlet obstruction: a comparative clinical study in patients undergoing restorative proctocolectomy and ileal pouch-anal anastomosis.
Surg Today
October 2024
Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
Article Synopsis
- - The study investigates the effectiveness of loop-end ileostomy (EI), introduced in 2021, in reducing stoma outlet obstruction (SOO) in patients undergoing restorative proctocolectomy (RPC) and ileal pouch-anal anastomosis (IPAA), compared to traditional loop ileostomy (LI).
- - Researchers analyzed 106 patients with diverting ileostomy, finding that EI significantly lowered the incidence of SOO (odds ratio 0.18) despite similar patient characteristics and surgery factors between the two groups.
- - The conclusion suggests that EI is a promising approach to minimize SOO complications following RPC and IPAA, particularly in more complex anastomosis cases.
Surgical management of anastomotic leakage related to ovarian cancer surgery: a narrative review.
Front Surg
September 2024
Department of Medical Area (DMED), Clinic of Obstetrics and Gynecology Unit, Santa Maria Della Misericordia Hospital, Azienda Sanitaria Friuli Centrale, Udine, Italy.
This narrative review describes the state of the art in the management of anastomotic leakage in ovarian cancer. Multiple surgical procedures, including bowel resection, are often required to achieve "optimal" cytoreduction in locally advanced ovarian cancer. Intestinal anastomosis is currently the most common way to restore bowel continuity.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!