We have located links that may give you full text access.
JOURNAL ARTICLE
RESEARCH SUPPORT, NON-U.S. GOV'T
Current use of diverting stoma in anterior resection for cancer: population-based cohort study of total and partial mesorectal excision.
International Journal of Colorectal Disease 2016 March
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.
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.
Full text links
Related Resources
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app