ArticleAnnals of surgical oncology2015
Optimal Treatment Strategy in Rectal Cancer Surgery: Should We Be Cowboys or Chickens?
Article in Annals of surgical oncology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
23 citing papers in PubMed, 46 citations in OpenAlex.
- Open sphincter-preserving surgery of extraperitoneal rectal cancer without primary stoma and Fast Track Protocol.Il Giornale di chirurgiaTrial
- Transanal drainage tube versus diverting stoma for reducing anastomotic leakage after rectal cancer surgery: a systematic review and meta-analysis.Journal of gastrointestinal oncology · 2026Article
- Achieving Quality Outcomes at reduced costs in Robotic Rectal Cancer Surgery: A Tertiary Centre's experience with 330 Robotic Rectal Cancer resections.Journal of robotic surgery · 2026Article
- Double-tube end ileostomy: an alternative to classical defunctioning stoma in rectal surgery.Techniques in coloproctology · 2025Article
- From Diversion to Permanence: Trends in Ostomy Creation in Rectal Cancer Surgery.Journal of clinical medicine · 2025Review
- Clinical analysis of different intestinal reconstruction methods after primary cytoreductive surgery combined with rectal resection for advanced ovarian cancer.Frontiers in oncology · 2025Article
- Long-Term Functional Outcome After Early vs. Late Stoma Closure in Rectal Cancer Surgery: Sub-analysis of the Multicenter FORCE Trial.Journal of gastrointestinal cancer · 2024Article
- Article
- Impact of a diverting ileostomy in total mesorectal excision with primary anastomosis for rectal cancer.Surgical endoscopy · 2023Article
- The Selective Use of a Diverting Stoma in Rectal Surgery.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 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
- Permanent stoma rates after anterior resection for rectal cancer: risk prediction scoring using preoperative variables.The British journal of surgery · 2021Article
- Morbidity and costs of diverting ileostomy in transanal total mesorectal excision with primary anastomosis for rectal cancer.Techniques in coloproctology · 2021Article
- Hospital variation in sphincter-preservation rates in rectal cancer treatment: results of a population-based study in the Netherlands.BJS open · 2021Article
- The usefulness of transanal tube for reducing anastomotic leak in mid rectal cancer: compared to diverting stoma.Annals of surgical treatment and research · 2021Article
- Stoma reversal after intended restorative rectal cancer resection in Denmark: nationwide population-based study.BJS open · 2020Article
- Risk factors for nonclosure of defunctioning stoma and stoma-related complications among low rectal cancer patients after sphincter-preserving surgery.Chronic diseases and translational medicine · 2020Article
- A multicentre cohort study of serum and peritoneal biomarkers to predict anastomotic leakage after rectal cancer resection.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2020Article
- Early ileostomy reversal after minimally invasive surgery and ERAS program for mid and low rectal cancer.Updates in surgery · 2019Article
- Transanal total mesorectal excision: how are we doing so far?Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2019Article
Corrections and comments
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Authors and funding
8 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeSurgeons and hospitals are increasingly accountable for their postoperative complication rates, which may lead to risk adverse treatment strategies in rectal cancer surgery. It is not known whether a risk adverse strategy leads to providing better care. In this study, the association between the strategy of hospitals regarding defunctioning stoma construction and postoperative outcomes in rectal cancer treatment was evaluated.
methodsPopulation-based data of the Dutch Surgical Colorectal Audit, including 3,104 patients undergoing rectal cancer resection between January 2009 and July 2012 in 92 hospitals, were used. Hospital variation in (case-mix-adjusted) defunctioning stoma rates was calculated. Anastomotic leakage and 30-day mortality rates were compared in hospitals with a high and low tendency towards stoma construction.
resultsOf all patients, 76 % received a defunctioning stoma; 9.6 % of all patients developed anastomotic leakage. Overall postoperative mortality rate was 1.8 %. The hospitals' adjusted proportion of defunctioning stomas varied from 0 to 100 %, and there was no significant correlation between the hospitals' adjusted stoma and anastomotic leakage rate. Severe anastomotic leakage was similar (7.0 vs. 7.1 %; p = 0.95) in hospitals with the lowest and highest stoma rates. Mild leakage and postoperative mortality rates were higher in hospitals with high stoma rates.
conclusionsA high tendency towards stoma construction in rectal cancer surgery did not result in lower overall anastomotic leakage or mortality rates. It seems that the ability to select patients for stoma construction is the key towards preferable outcomes, not a risk adverse strategy.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.