umu.sePublications
Change search
ReferencesLink to record
Permanent link

Direct link
Current use of diverting stoma in anterior resection for cancer: population-based cohort study of total and partial mesorectal excision
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
Show others and affiliations
2016 (English)In: International Journal of Colorectal Disease, ISSN 0179-1958, E-ISSN 1432-1262, Vol. 31, no 3, 579-585 p.Article in journal (Refereed) PublishedText
Abstract [en]

Purpose A diverting stoma is commonly used to reduce the risk of anastomotic leakage when performing total mesorectal excision (TME) in anterior resection for rectal cancer. The purpose of this study was to evaluate the impact of fecal diversion in relation to partial mesorectal excision (PME).

Methods A retrospective analysis was undertaken on a national cohort, originally created to study the impact of central arterial ligation on patients with increased cardiovascular risk. Some 741 patients operated with anterior resection for rectal cancer during the years 2007 through 2010 were followed up for 53 months. Multivariate logistic regression was used to evaluate the impact of diverting stoma on the risk of anastomotic leakage and permanent stoma, expressed as odds ratios (ORs) and 95 % confidence intervals (CIs).

Results The risk of anastomotic leakage was increased in TME surgery when not using a diverting stoma (OR 5.1; 95 % CI 2.2-11.6), while the corresponding risk increase in PME patients was modest (OR 1.8; 95 % CI 0.8-4.0). At study completion or death, 26 and 13 % of TME and PME patients, respectively, had a permanent stoma. A diverting stoma was a statistically significant risk factor for a permanent stoma in PME patients (OR 4.7; 95 % CI 2.5-9.0), while less important in TME patients (OR 1.8; 95 % CI 0.6-5.5).

Conclusion The benefit of a diverting stoma concerning anastomotic leakage in this patient group seems doubtful. Moreover, the diverting stoma itself may contribute to the high rate of permanent stomas.

Place, publisher, year, edition, pages
2016. Vol. 31, no 3, 579-585 p.
Keyword [en]
Rectal cancer, Defunctioning stoma, Fecal diversion, Permanent stoma
National Category
Surgery Gastroenterology and Hepatology
Identifiers
URN: urn:nbn:se:umu:diva-118987DOI: 10.1007/s00384-015-2465-6ISI: 000371400900012PubMedID: 26670673OAI: oai:DiVA.org:umu-118987DiVA: diva2:925879
Available from: 2016-05-03 Created: 2016-04-07 Last updated: 2016-05-03Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Rutegård, MartinBoström, PetrusHaapamäki, MarkkuRutegård, Jörgen
By organisation
Department of Surgical and Perioperative Sciences
In the same journal
International Journal of Colorectal Disease
SurgeryGastroenterology and Hepatology

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 5 hits
ReferencesLink to record
Permanent link

Direct link