Observational studyBJS open2023
Defunctioning loop ileostomy in anterior resection for rectal cancer and subsequent renal failure: nationwide population-based study.
Observational study in BJS open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 17 papers, 1 of them a synthesis that pooled it.
What it found
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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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Management of anastomotic leak after elective anterior resection for rectal cancer: A systematic review and pooled analysis.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2025Pooled it
- Development and validation of an anastomotic risk score for use in a randomized clinical trial on defunctioning stoma use in low anterior resection for rectal cancer.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2025Trial
- Article
- Optimal timing of ileostomy closure after rectal surgery: A Bayesian network meta-analysis of randomized controlled trials.Langenbeck's archives of surgery · 2026Review
- Safety and effectiveness of the Colovac anastomosis protection device compared with diverting ileostomy after low anterior resection: protocol for an international, multicentre, prospective, non-randomised comparative study (SAFE-3).BMJ open gastroenterology · 2026Article
- Impact of Renin-Angiotensin System Inhibitors on Renal Function During Temporary Ileostomy Period in Rectal Cancer Patients: A Retrospective Cohort Study.Annals of gastroenterological surgery · 2026Article
- Chronic Diseases Related to Diet and/or Nutrition in Patients With an Ileostomy - A Scoping Review.Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2025Article
- Machine learning prediction model of prolonged delay to loop ileostomy closure after rectal cancer surgery: a retrospective study.World journal of surgical oncology · 2025Article
- Article
- Increased risk of postoperative complications after delayed stoma reversal: a multicenter retrospective cohort study on patients undergoing anterior resection for rectal cancer.International journal of colorectal disease · 2025Article
- SELective defunctioning Stoma Approach in low anterior resection for rectal cancer (SELSA): Protocol for a prospective study with a nested randomized clinical trial investigating stoma-free survival without major LARS following total mesorectal excision.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2025Article
- Risk of Kidney Failure in Patients With Inflammatory Bowel Disease Undergoing Colectomy: A Nationwide Cohort Study.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2024Article
- Modified delayed coloanal anastomosis following TME for mid and low rectal cancer: 19 consecutive patients from a single center.Updates in surgery · 2024Article
- Article
- Article
- Robotic low anterior resection with complete splenic flexure mobilization and defunctioning left-sided loop colostomy: a case series.Journal of surgical case reports · 2024Article
- Renal failure as a complication of defunctioning ileostomy: more complexity to a complex decision-making process.BJS open · 2023Article
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundElectrolyte disturbances and dehydration are common after anterior resection for rectal cancer with a defunctioning loop ileostomy. High-quality population-based studies on the impact of a defunctioning loop ileostomy on renal failure are lacking.
methodsThis was a nationwide observational study, based on the Swedish Colorectal Cancer Registry of patients undergoing anterior resection for rectal cancer between 2008 and 2016, with follow-up until 2017. Patients with severe co-morbidity, with age greater than 80 years, and with pre-existing renal failure were excluded. Loop ileostomy at index surgery constituted exposure, while a diagnosis of renal failure was the outcome. Acute and chronic events were analysed separately. Inverse probability weighting with adjustment for confounding derived from a causal diagram was employed. Hazards ratios (HRs) with 95 per cent c.i. are reported.
resultsA total of 5355 patients were eligible for analysis. At 5-year follow-up, all renal failure events (acute and chronic) were 7.2 per cent and 3.3 per cent in the defunctioning stoma and no stoma groups respectively. In the weighted analysis, a HR of 11.59 (95 per cent c.i. 5.68 to 23.65) for renal failure in ostomates was detected at 1 year, with the largest effect from acute renal failure (HR 24.04 (95 per cent c.i. 8.38 to 68.93)). Later follow-up demonstrated a similar pattern, but with smaller effect sizes.
conclusionPatients having a loop ileostomy in combination with anterior resection for rectal cancer are more likely to have renal failure, especially early after surgery. Strategies are needed, such as careful fluid management protocols, and further research into alternative stoma types or reduction in stoma formation.
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