Diverting stomas reduce reoperation rates for anastomotic leak but not overall reoperation rates within 30 days after anterior rectal resection: ... View Full Text


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Article Info

DATE

2022-06-24

AUTHORS

Elisabeth Myrseth, Linn Såve Nymo, Petter Fosse Gjessing, Stig Norderval

ABSTRACT

PurposeA diverting stoma is commonly formed to reduce the rate of anastomotic leak following anterior resection with anastomosis, although some studies question this strategy. The aim of this study was to assess the leak rates and overall complication burden after anterior resection with and without a diverting stoma.MethodsA 5-year national cohort with prospectively registered data of patients who underwent elective anterior resection for rectal cancer located < 15 cm from the anal verge. Data were retrieved from the Norwegian Registry for Gastrointestinal Surgery and the Norwegian Colorectal Cancer Registry. Primary end point was relaparotomy or relaparoscopy for anastomotic leak within 30 days from index surgery. Secondary endpoints were postoperative complications including reoperation for any cause.ResultsSome 1018 patients were included of whom 567 had a diverting stoma and 451 had not. Rate of reoperation for anastomotic leak was 13 out of 567 (2.3%) for patients with diverting stoma and 35 out of 451 (7.8%) (p > 0.001) for patients without. In multivariable analyses not having a diverting stoma (aOR 3.77, c.i 1.97–7.24, p < 0.001) was associated with increased risk for anastomotic leak. However, there were no differences in overall reoperation rates following anterior resection with or without diverting stoma (9.3% vs 10.9%, p = 0.423), and overall complication rates were similar. Reoperation was associated with increased mortality irrespective of the main intraoperative finding.ConclusionDiverting stoma formation after anterior resection is protective against reoperation for anastomotic leak but does not affect overall rates of reoperation or complications within 30 days. More... »

PAGES

1681-1688

References to SciGraph publications

  • 2020-08-14. Risk factors for anastomotic leakage and its impact on long-term survival in left-sided colorectal cancer surgery in WORLD JOURNAL OF SURGICAL ONCOLOGY
  • 2013-02-06. Anastomotic Leak Following Low Anterior Resection in Stage IV Rectal Cancer is Associated with Poor Survival in ANNALS OF SURGICAL ONCOLOGY
  • 2018-05-17. Defunctioning Stomas Result in Significantly More Short-Term Complications Following Low Anterior Resection for Rectal Cancer in WORLD JOURNAL OF SURGERY
  • 2021-03-17. Risk Factors for Anastomotic Leakage in Patients with Rectal Tumors Undergoing Anterior Resection within an ERAS Protocol: Results from the Swedish ERAS Database in WORLD JOURNAL OF SURGERY
  • 2019-01-08. Laparoscopic vs. robotic rectal cancer surgery and the effect on conversion rates: a meta-analysis of randomized controlled trials and propensity-score-matched studies in TECHNIQUES IN COLOPROCTOLOGY
  • 2020-08-20. Long term outcome of anastomotic leakage in patients undergoing low anterior resection for rectal cancer in BMC CANCER
  • 2017-01-27. Functional outcome following rectal surgery—predisposing factors for low anterior resection syndrome in INTERNATIONAL JOURNAL OF COLORECTAL DISEASE
  • 2020-05-05. Late anastomotic leakage after anal sphincter saving surgery for rectal cancer: is it different from early anastomotic leakage? in INTERNATIONAL JOURNAL OF COLORECTAL DISEASE
  • 2020-10-15. IMARI: multi-Interventional program for prevention and early Management of Anastomotic leakage after low anterior resection in Rectal cancer patIents: rationale and study protocol in BMC SURGERY
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    http://scigraph.springernature.com/pub.10.1007/s00384-022-04205-8

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    http://dx.doi.org/10.1007/s00384-022-04205-8

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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/35739403


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