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What is the risk of permanent stoma beyond 5 years after low anterior resection for rectal cancer? A 15-year follow-up of a randomized trial.
Gadan, S; Floodeen, H; Lindgren, R; Rutegård, M; Matthiessen, P.
Afiliación
  • Gadan S; Department of Surgery, Örebro University Hospital, Örebro, Sweden.
  • Floodeen H; Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
  • Lindgren R; Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
  • Rutegård M; Department of Surgery, Örebro University Hospital, Örebro, Sweden.
  • Matthiessen P; Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden.
Colorectal Dis ; 22(12): 2098-2104, 2020 12.
Article en En | MEDLINE | ID: mdl-32931137
AIM: Low anterior resection of the rectum for cancer (LAR) entails a risk of symptomatic anastomotic leakage as well as impaired anorectal function, both of which may eventually result in the need for a permanent stoma (PS). The aim was to investigate the incidence of and risk factors for PS beyond 5 years following LAR. METHODS: Patients undergoing LAR and included in a multicentre trial with randomization to defunctioning stoma or not were followed for a median of 15 years. The reasons for a PS up to 5 years (PS ≤ 5 years) and beyond 5 years (PS > 5 years) were identified and compared. Risk factors for PS were analysed. RESULTS: Of all patients, 25% (57/232) had a PS. PS ≤ 5 years occurred in 19% (44/232) at a median of 12.5 months and PS > 5 years in 6% (13/232) at a median of 118 months following LAR. The main reason for PS ≤ 5 years was impaired anorectal function in 55% (24/44) and the main reason for PS > 5 years was pelvic sepsis related to the colorectal anastomosis in 46% (6/13). The major risk factor for PS was symptomatic anastomotic leakage, which occurred in 56% (32/57) of patients with PS and 10% (17/175) of patients without PS (P < 0.001). CONCLUSION: One-fourth of the patients who ended up with a PS had it fashioned beyond 5 years at a median of 10 years following LAR. Symptomatic anastomotic leakage was the major risk factor for PS, and impaired anorectal function was the main overall reason for a PS.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias del Recto / Estomas Quirúrgicos / Proctectomía Tipo de estudio: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Colorectal Dis Asunto de la revista: GASTROENTEROLOGIA Año: 2020 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias del Recto / Estomas Quirúrgicos / Proctectomía Tipo de estudio: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Colorectal Dis Asunto de la revista: GASTROENTEROLOGIA Año: 2020 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Reino Unido