ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2014
High 1-year complication rate after anterior resection for rectal cancer.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Conversations for providers caring for patients with rectal cancer: Comparison of long-term patient-centered outcomes for patients with low rectal cancer facing ostomy or sphincter-sparing surgery.CA: a cancer journal for clinicians · 2016Pooled it
- The Tumour Immune Microenvironment as a Predictor of the Response to Neoadjuvant Therapy in Rectal Cancer.Cancers · 2026Review
- Reactivation leakages following stoma reversal after rectal cancer surgery: an underestimated problem.BJS open · 2024Article
- Stoma-free survival after anastomotic leak following rectal cancer resection: worldwide cohort of 2470 patients.The British journal of surgery · 2023Article
- Assessing the predictive value of clinical factors to pathological complete response for locally advanced rectal cancer: An analysis of 124 patients.Frontiers in oncology · 2023Article
- Clinical prediction model of pathological response following neoadjuvant chemoradiotherapy for rectal cancer.Scientific reports · 2022Article
- Long-term stoma-related reinterventions after anterior resection for rectal cancer with or without anastomosis: population data from the Dutch snapshot study.Techniques in coloproctology · 2022Article
- The impact of sarcopenia on pathologic complete response following neoadjuvant chemoradiation in rectal cancer.Langenbeck's archives of surgery · 2020Article
- Late anastomotic leakage after anal sphincter saving surgery for rectal cancer: is it different from early anastomotic leakage?International journal of colorectal disease · 2020Article
- Predictors and Risk Factors of Pathologic Complete Response Following Neoadjuvant Chemoradiotherapy for Rectal Cancer: A Population-Based Analysis.Frontiers in oncology · 2019Article
- Local antibiotic decontamination to prevent anastomotic leakage short-term outcome in rectal cancer surgery.International journal of colorectal disease · 2018Article
- Optimal Treatment Strategy in Rectal Cancer Surgery: Should We Be Cowboys or Chickens?Annals of surgical oncology · 2015Article
- The outcome of local excision of large rectal polyps by transanal endoscopic microsurgery.Journal of minimal access surgeryArticle
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10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSurgical options after anterior resection for rectal cancer include a primary anastomosis, anastomosis with a defunctioning stoma, and an end colostomy. This study describes short-term and 1-year outcomes of these different surgical strategies.
methodsPatients undergoing surgical resection for primary mid and high rectal cancer were retrospectively studied in seven Dutch hospitals with 1-year follow-up. Short-term endpoints were postoperative complications, re-interventions, prolonged hospital stay, and mortality. One-year endpoints were unplanned readmissions and re-interventions, presence of stoma, and mortality.
resultsNineteen percent of 388 included patients received a primary anastomosis, 55% an anastomosis with defunctioning stoma, and 27% an end colostomy. Short-term anastomotic leakage was 10% in patients with a primary anastomosis vs. 7% with a defunctioning stoma (P = 0.46). An end colostomy was associated with less severe re-interventions. One-year outcomes showed low morbidity and mortality rates in patients with an anastomosis. Patients with a defunctioning stoma had high (18%) readmissions and re-intervention (12%) rates, mostly due to anastomotic leakage. An end colostomy was associated with unplanned re-interventions due to stoma/abscess problems. During follow-up, there was a 30% increase in patients with an end colostomy.
conclusionsThis study showed a high 1-year morbidity rate after anterior resection for rectal cancer. A defunctioning stoma was associated with a high risk for late complications including anastomotic leakage. An end colostomy is a safe alternative to prevent anastomotic leakage, but stomal problems cannot be ignored. Selecting low-risk patients for an anastomosis may lead to favorable short- and 1-year outcomes.
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