ArticleWorld journal of surgery2018
Defunctioning Stomas Result in Significantly More Short-Term Complications Following Low Anterior Resection for Rectal Cancer.
Article in World journal of surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A meta-analysis of the role of diverting ileostomy after rectal cancer surgery.International journal of colorectal disease · 2021Pooled it
- Article
- The short-term effect of Da Vinci's robot total mesorectal excision with preserving the left colic artery.Medicine · 2025Article
- Patient selection and operative strategies for laparoscopic intersphincteric resection without diverting stoma.World journal of gastrointestinal surgery · 2025Article
- Effects of high-quality nursing on surgical site wound infections after colostomy in patients with colorectal cancer.World journal of gastrointestinal surgery · 2024Article
- Benefits and risks of diverting stoma creation during rectal cancer surgery.Annals of coloproctology · 2024Article
- RETRACTED: Effects of quality nursing on the surgical site wound infection after colostomy in patients with colorectal cancer: A meta-analysis.International wound journal · 2024Article
- Evaluation of the SafeHeal Colovac+ anastomosis protection device after low anterior resection for rectal cancer: the safe anastomosis feasibility evaluation (SAFE) 2019 trial.Surgical endoscopy · 2023Article
- Assessment of the efficacy of Handmade Vacuum-Assisted Sponge Drain for Treatment of Anastomotic leakage after Low Anterior Rectal Resection.Updates in surgery · 2023Article
- Impact of a diverting ileostomy in total mesorectal excision with primary anastomosis for rectal cancer.Surgical endoscopy · 2023Article
- Modified Primary Anastomosis Using an Intestinal Internal Drainage Tube for Crohn's Disease: A Pilot Study.Journal of clinical medicine · 2023Article
- Diverting stomas reduce reoperation rates for anastomotic leak but not overall reoperation rates within 30 days after anterior rectal resection: a national cohort study.International journal of colorectal disease · 2022Article
- Impact of fast-track care program in laparoscopic rectal cancer surgery: a cohort-comparative study.Surgical endoscopy · 2022Observational
- 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
- Morbidity and costs of diverting ileostomy in transanal total mesorectal excision with primary anastomosis for rectal cancer.Techniques in coloproctology · 2021Article
- The influence of predictive nursing on the emotions and self-management abilities of post-colostomy rectal cancer patients.American journal of translational research · 2021Article
- Neoadjuvant radiotherapy for rectal cancer management.World journal of gastroenterology · 2019Review
- Protection of colorectal anastomosis with an intraluminal bypass device for patients undergoing an elective anterior resection: a pilot study.Techniques in coloproctology · 2019Article
- Endoscopic resection of colorectal circumferential and near-circumferential laterally spreading lesions: outcomes and risk of stenosis.International journal of colorectal disease · 2019Article
- First, Do No Harm: Rethinking Routine Diversion in Sphincter-Preserving Rectal Cancer Resection.Journal of the American College of Surgeons · 2019Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundStudies suggest that defunctioning stomas reduce the rate of anastomotic leakage and urgent reoperations after anterior resection. Although the magnitude of benefit appears to be limited, there has been a trend in recent years towards routinely creating defunctioning stomas. However, little is known about post-operative complication rates in patients with and without a defunctioning stoma. We compared overall short-term post-operative complications after low anterior resection in patients managed with a defunctioning stoma to those managed without a stoma.
methodsA retrospective cohort study of patients undergoing elective low anterior resection of the rectum for rectal cancer. The primary outcome was overall 90-day post-operative complications.
resultsTwo hundred and three patients met the inclusion criteria for low anterior resection. One hundred and forty (69%) had a primary defunctioning stoma created. 45% received neoadjuvant radiotherapy. Patients with a defunctioning stoma had significantly more complications (57.1 vs 34.9%, p = 0.003), were more likely to suffer multiple complications (17.9 vs 3.2%, p < 0.004) and had longer hospital stays (13.0 vs 6.9 days, p = 0.005) than those without a stoma. 19% experienced a stoma-related complication, 56% still had a stoma 1 year after their surgery, and 26% were left with a stoma at their last follow-up. Anastomotic leak rates were similar but there was a significantly higher reoperation rate among patients managed without a defunctioning stoma.
conclusionPatients selected to have a defunctioning stoma had an absolute increase of 22% in overall post-operative complications compared to those managed without a stoma. These findings support the more selective use of defunctioning stomas. STUDY REGISTRATION: Registered at www.researchregistry.com (UIN: researchregistry3412).
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