ArticleBMC surgery2023
Defunctioning stoma in anterior resection for rectal cancer does not impact anastomotic leakage: a national population-based cohort study.
Article in BMC surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.
- Higher BMI increases risk of stoma-site incisional hernia and other complications following diverting loop ileostomy and reversal: a systematic review and meta-analysis.Surgical endoscopy · 2025Pooled it
- Optimal timing of ileostomy closure after rectal surgery: A Bayesian network meta-analysis of randomized controlled trials.Langenbeck's archives of surgery · 2026Review
- Performance and safety of the Colovac 2 colorectal anastomotic protection device: the SafeHeal SAFE-2023 study.Surgical endoscopy · 2026Article
- Short-term outcomes of low anterior resection with and without ileostomy for low, mid and upper rectal cancers.Updates in surgery · 2025Article
- 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
- Outcome of selective non-diverting low anterior resection after neoadjuvant chemoradiotherapy and curative surgery for proximal rectal cancer: A prospective case series.Middle East journal of digestive diseases · 2024Article
- An Alteration to Standardized Treatments: Defunctioning Colostomy in Ultra-Low Stage IIIC Rectal Adenocarcinoma.Kansas journal of medicineArticle
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAnterior resection (AR) is considered the gold standard for curative cancer treatment in the middle and upper rectum. The goal of the sphincter-preserving procedure, such as AR, is vulnerable to anastomotic leak (AL) complications. Defunctioning stoma (DS) became the protective measure against AL. Often a defunctioning loop-ileostomy is used, which is associated with substantial morbidity. However, not much is known if the routine use of DS reduces the overall incidence of AL.
methodsElective patients subjected to AR in 2007-2009 and 2016-18 were recruited from the Swedish colorectal cancer registry (SCRCR). Patient characteristics, including DS status and occurrence of AL, were analyzed. In addition, independent risk factors for AL were investigated by multivariable regression.
resultsThe statistical increase of DS from 71.6% in 2007-2009 to 76.7% in 2016-2018 did not impact the incidence of AL (9.2% and 8.2%), respectively. DLI was constructed in more than 35% of high-located tumors ≥ 11 cm from the anal verge. Multivariable analysis showed that male gender, ASA 3-4, BMI > 30 kg/m
conclusionRoutine DS did not decrease overall AL after AR. A selective decision algorithm for DS construction is needed to protect from AL and mitigate DS morbidities.
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