Risk Factors for Radical Rectal Cancer Surgery with a Temporary Stoma Becoming a Permanent Stoma: A Pooling Up Analysis.

Purpose: The aim of this study was to find out the potential risk factors for the formation of a permanent stoma (PS) for rectal cancer patients with a temporary stoma (TS) after surgery. Methods: PubMed, Embase, and the Cochrane Library were searched for eligible studies until November 14, 2022. The patients were divided into the PS group and the TS group. Odds ratio (ORs) and 95% confidence intervals (CIs) were pooled up for describing dichotomous variables. Stata SE 16 was performed for data analysis. Results: After pooling up the data, a total of 14 studies involving 14,265 patients were included in this study. The outcomes showed that age (OR = 1.03, 95% CI = 0.96 to 1.10, I 2  = 1.42%, P  = .00 < .1), surgery type ( P  = .00 < .1), tumor stage ( P  = .00 < .1), preoperative chemoradiotherapy ( P  = .00 < .1), preoperative radiotherapy ( P  = .01 < .1), neoadjuvant therapy ( P  = .00 < .1), American Society of Anesthesiologists (ASA) score of ≥3 ( P  = .00 < .1), anastomotic leakage ( P  = .01 < .1), local recurrence ( P  = .00 < .1), and distant recurrence ( P  = .00 < .1) were associated with the patient with PS. However, sex ( P  = .15 > .1), previous abdominal surgery ( P  = .84 > .1), adjuvant chemotherapy ( P  = .87 > .1), and defunctioning stoma ( P  = .1) had little association with PS. Conclusion: Patients who were elderly, had advanced tumor stages, had a high ASA score, and underwent neoadjuvant therapy should be informed of the high risk of PS before surgery. Meanwhile, those who underwent rectal cancer surgery with a TS should beware of anastomotic leakage, local recurrences, and distant recurrences, which could increase the risk of PS.