ArticleSurgical endoscopy2023
Impact of a diverting ileostomy in total mesorectal excision with primary anastomosis for rectal cancer.
Article in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 11 citations in OpenAlex.
- Multicenter phase II trial of transanal total mesorectal excision for rectal cancer: preliminary results.Surgical endoscopy · 2023Trial
- Letter to Editor of Annals of Surgical Oncology Concerning "Risk Factors for and Oncologic Impact of Anastomotic Leakage After Sphincter-Preserving Proctectomy for Mid/Low Rectal Cancer: A Multi-institutional Cohort Study in Japan".Annals of surgical oncology · 2026Article
- Comparison analysis of short-term outcomes between degradable stent placement and diverting ileostomy in mid-to-low rectal cancer: a retrospective cohort study.Updates in surgery · 2026Article
- Optimal timing of ileostomy closure after rectal surgery: A Bayesian network meta-analysis of randomized controlled trials.Langenbeck's archives of surgery · 2026Review
- Prophylactic ileostomy vs. nonprophylactic ileostomy in laparoscopic low anterior resection for rectal cancer (PILLAR): a prospective, multicenter, cohort study in china.International journal of surgery (London, England) · 2025Article
- Risk Factors for and Oncologic Impact of Anastomotic Leakage After Sphincter-Preserving Proctectomy for Mid/Low Rectal Cancer: A Multi-institutional Cohort Study in Japan.Annals of surgical oncology · 2025Article
- Impact of Surgical Approach, Patient Risk Factors, and Diverting Ileostomy on Anastomotic Leakage and Outcomes After Rectal Cancer Resection: A 5-Year Single-Center Study.Medicina (Kaunas, Lithuania) · 2025Article
- Patient selection and operative strategies for laparoscopic intersphincteric resection without diverting stoma.World journal of gastrointestinal surgery · 2025Article
- An Institutional Shift from Routine to Selective Diversion of Low Anastomosis in Robotic TME Surgery for Rectal Cancer Patients Using the KHANS Technique: A Single-Centre Cohort Study.Journal of personalized medicine · 2024Article
- Modified pull-through coloanal anastomosis to avoid permanent stomas and reduce postoperative complications for lower rectal tumors.Surgical endoscopy · 2023Article
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Authors and funding
15 authors at 9 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe role of diverting ileostomy in total mesorectal excision (TME) for rectal cancer with primary anastomosis is debated. The aim of this study is to gain insight in the clinical consequences of a diverting ileostomy, with respect to stoma rate at one year and stoma-related morbidity.
methodsPatients undergoing TME with primary anastomosis for rectal cancer between 2015 and 2017 in eleven participating hospitals were included. Retrospectively, two groups were compared: patients with or without diverting ileostomy construction during primary surgery. Primary endpoint was stoma rate at one year. Secondary endpoints were severity and rate of anastomotic leakage, overall morbidity rate within thirty days and stoma (reversal) related morbidity.
resultsIn 353 out of 595 patients (59.3%) a diverting ileostomy was constructed during primary surgery. Stoma rate at one year was 9.9% in the non-ileostomy group and 18.7% in the ileostomy group (p = 0.003). After correction for confounders, multivariate analysis showed that the construction of a diverting ileostomy during primary surgery was an independent risk factor for stoma at one year (OR 2.563 (95%CI 1.424-4.611), p = 0.002). Anastomotic leakage rate was 17.8% in the non-ileostomy group and 17.2% in the ileostomy group (p = 0.913). Overall 30-days morbidity rate was 37.6% in the non-ileostomy group and 56.1% in the ileostomy group (p < 0.001). Stoma reversal related morbidity rate was 17.9%.
conclusionsThe stoma rate at one year was higher in patients with ileostomy construction during primary surgery. The incidence and severity of anastomotic leakage were not reduced by construction of an ileostomy. The morbidity related to the presence and reversal of a diverting ileostomy was substantial.
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