Evidence map›Paper›PMID 40597683›Full record

SynthesisBMC gastroenterology2025

Post-surgical morbidity in early versus late closure of defunctioning ileostomy after rectal cancer surgery: A systematic review and meta-analysis of randomised controlled trials.

Dedrick Kok Hong Chan, Jerrald Lau, Jarrod Kah-Hwee Tan, Bryan Jun Liang Buan, Kai-Yin Lee, Norman Sihan Lin, Ian Jse-Wei Tan, Jing-Yu Ng, Bettina Lieske, Wai-Kit Cheong and 1 more

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMC gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Early Closure of Diverting Ileostomy After Rectal Resection: Are We Ready to Make the Shift?Acta informatica medica : AIM : journal of the Society for Medical Informatics of Bosnia & Herzegovina : casopis Drustva za medicinsku informatiku BiH · 2025
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Dedrick Kok Hong ChanDivision of Colorectal Surgery, National University Hospital, NUHS Tower Block, Level 8, 1E Kent Ridge Road, Singapore, 119228, Singapore. dedrick_kh_chan@nuhs.edu.sg.
Jerrald LauDepartment of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Jarrod Kah-Hwee TanDivision of Colorectal Surgery, National University Hospital, NUHS Tower Block, Level 8, 1E Kent Ridge Road, Singapore, 119228, Singapore.
Bryan Jun Liang BuanDivision of Colorectal Surgery, National University Hospital, NUHS Tower Block, Level 8, 1E Kent Ridge Road, Singapore, 119228, Singapore.
Kai-Yin LeeDivision of Colorectal Surgery, National University Hospital, NUHS Tower Block, Level 8, 1E Kent Ridge Road, Singapore, 119228, Singapore.
Norman Sihan LinDivision of Colorectal Surgery, National University Hospital, NUHS Tower Block, Level 8, 1E Kent Ridge Road, Singapore, 119228, Singapore.
Ian Jse-Wei TanDivision of Colorectal Surgery, National University Hospital, NUHS Tower Block, Level 8, 1E Kent Ridge Road, Singapore, 119228, Singapore.
Jing-Yu NgDivision of Colorectal Surgery, National University Hospital, NUHS Tower Block, Level 8, 1E Kent Ridge Road, Singapore, 119228, Singapore.
Bettina LieskeDivision of Colorectal Surgery, National University Hospital, NUHS Tower Block, Level 8, 1E Kent Ridge Road, Singapore, 119228, Singapore.
Wai-Kit CheongDivision of Colorectal Surgery, National University Hospital, NUHS Tower Block, Level 8, 1E Kent Ridge Road, Singapore, 119228, Singapore.
Ker-Kan TanDivision of Colorectal Surgery, National University Hospital, NUHS Tower Block, Level 8, 1E Kent Ridge Road, Singapore, 119228, Singapore.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA defunctioning ileostomy is frequently created to avert the implications of a colo-rectal anastomotic dehiscence in rectal cancer surgery. The timing of closure of the ileostomy remains debatable as it is believed that early closure (EC) may be beneficial to most patients than the standard practice of late closure (LC). This meta-analysis was performed to compare surgical outcomes in patients who underwent EC versus LC.

methodsRandomised controlled trials (RCT) which evaluated the effect of EC versus LC of ileostomy on surgical outcomes in rectal cancer patients was searched on PubMed, Web of Science, Embase and Cochrane Library. RCTs evaluating EC vs. LC of defunctioning ileostomies for rectal cancer patients were included. The primary outcome measures include overall morbidity, surgical complications, anastomotic dehiscence, and reoperation rates.

resultsFive RCTs were included in this meta-analysis of 387 patients. The pooled estimate of the OR for overall morbidity (OR 1.80, 95% CI 0.97-3.31; p = 0.06), reoperation (OR 2.57, 95% CI 0.72-9.14; p = 0.14), and anastomotic leakage (OR 3.25, 95% CI 0.40-26.38; p = 0.27) were not statistically significant. EC however resulted in a statistically significant increase in terms of surgical complications (OR 2.63, 95% CI 1.04-6.67; p = 0.04). These studies had low to moderate levels of statistical heterogeneity.

conclusionEC of defunctioning ileostomy in rectal cancer patients results in increased surgical complications compared to patients with LC. Caution must be undertaken in patients in whom an EC is performed.

Indexed as

IleostomyPostoperative ComplicationsRectal NeoplasmsAnastomotic LeakHumansRandomized Controlled Trials as TopicReoperationSurgical Wound DehiscenceTime FactorsEarly closureIleostomyMeta-analysisMorbidityRectal cancer

Identifiers

PMID40597683
PMCPMC12211236

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.