ArticleBJS open2022
Clostridium difficile infection after ileostomy closure and anastomotic failure in rectal cancer surgery patients.
Article in BJS open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.
- Clostridium difficile infection after stoma reversal surgery: a systematic review and meta-analysis of the literature.International journal of colorectal disease · 2024Pooled it
- Risk factors and outcomes of Clostridioides difficile infection in patients with colorectal cancer: critical perspective in management.Gut pathogens · 2025Review
- Impact of Clostridium difficile Infection Versus Colonization on Postoperative Outcomes After Oncological Colorectal Surgery: An Observational Single-Center Study With Propensity Score Analysis.Journal of surgical oncology · 2025Observational
- Predictive factors for intrathoracic anastomotic leakage and postoperative mortality after esophageal cancer resection.BMC surgery · 2024Article
- Development and evaluation of a rapid visual loop-mediated isothermal amplification assay for thePeerJ · 2024Article
- Predictors of Clostridium difficile infection after stoma reversal following TaTME surgery.Updates in surgery · 2023Article
Corrections and comments
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDiverting ileostomy during resection of rectal cancer is frequently performed in patients at risk of anastomotic failure. Clostridium difficile infection (CDI) is reported to be frequent in patients who receive ileostomy closure with a questionable association to postoperative anastomosis leak. The primary aim of this study was to determine the incidence of CDI following ileostomy closure in patients who underwent rectal cancer surgery; the secondary aim was to assess the rate of postileostomy closure CDI in patients who presented with leakage at the original colorectal anastomosis site.
methodsMedical records of patients with rectal cancer who underwent ileostomy closure between January 2015 and December 2019 were retrospectively reviewed. All patients had previously received resection and anastomosis for primary rectal cancer with diverting ileostomy. Data regarding CDI incidence, preoperative status, perioperative management, and clinical outcomes were collected. CDI positivity was determined by direct real-time PCR and enzyme-linked fluorescent assays for detecting toxin A and B.Statistical analyses were computed for CDI risk factors.
resultsA total of 1270 patients were included and 208 patients were tested for CDI owing to colitis-related symptoms. The incidence of CDI was 3.6 per cent (46 patients). Multivariable analysis for CDI risk factors identified adjuvant chemotherapy (hazard ratio (HR) 2.28; P = 0.034) and colorectal anastomosis leakage prior to CDI (HR 3.75; P = 0.008). Finally, patients with CDI showed higher colorectal anastomosis leakage risk in multivariable analysis after ileostomy closure (HR 6.922; P = 0.001).
conclusionPatients with CDI presented with a significantly higher rate of colorectal anastomosis leakage prior to ileostomy closure.
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