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Long distance to hospital is not a risk factor for non-reversal of a defunctioning stoma
Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap. (Clister)ORCID-id: 0000-0001-5076-7400
Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap. (Clister)
Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap. (Clister)
2019 (Engelska)Ingår i: International Journal of Colorectal Disease, ISSN 0179-1958, E-ISSN 1432-1262, Vol. 34, nr 6, s. 993-1000Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

PURPOSE: To see if road distance to hospital influences stoma reversal rate, time from index operation to stoma reversal, and occurrence of permanent stoma.

METHODS: Data from all diagnosed cases of rectal cancer from three counties in northern Sweden were extracted from the Swedish Rectal Cancer Registry. The three counties are sparsely populated, with a population density roughly one fifth the average density in Sweden. Distances to nearest, operating, and largest hospital were obtained using Google Maps™. Matched data on socioeconomic variables were retrieved from Statistics Sweden.

RESULTS: In univariate logistic regression analysis, patients living closer to the operating hospital had a higher likelihood of non-reversal than those living farther away (OR 0.3; 95% CI 0.12-0.76). However, no difference was seen in the multivariate analysis. Of the 717 cases included, 54% received a permanent stoma and 38% a defunctioning stoma at index surgery. The reversal rate of a defunctioning stoma was 83%. At follow-up, 61% still had a stoma, 89% of these were permanent, and 11% non-reversed defunctioning stomas. Median time to stoma reversal was 287 days (82-1557 days). Of all 227 stoma reversals, 77% were done more than 6 months after index surgery.

CONCLUSIONS: Longer distance to hospital is not a risk factor for non-reversal of a defunctioning stoma. Only 23% had their defunctioning stoma reversed within 6 months after index surgery. Future studies aiming to determine reversal rate need to extend their follow-up time in order to receive accurate results.

Ort, förlag, år, upplaga, sidor
Springer, 2019. Vol. 34, nr 6, s. 993-1000
Nyckelord [en]
Defunctioning stoma, Distance, Permanent stoma, Rectal cancer, Rural, Stoma reversal
Nationell ämneskategori
Kirurgi
Identifikatorer
URN: urn:nbn:se:umu:diva-156475DOI: 10.1007/s00384-019-03258-6PubMedID: 30747282OAI: oai:DiVA.org:umu-156475DiVA, id: diva2:1289410
Forskningsfinansiär
Västerbottens läns landsting, VLL-675981Tillgänglig från: 2019-02-18 Skapad: 2019-02-18 Senast uppdaterad: 2019-06-11Bibliografiskt granskad

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Näverlo, SimonStrigård, KarinGunnarsson, Ulf

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