Clinical Outcomes of Ileostomy Closure during versus after Adjuvant Chemotherapy in Patients with Rectal Cancer

被引:0
作者
He, Fan [1 ]
Yang, Fuyu [1 ]
Tang, Chenglin [1 ]
Chen, Defei [1 ]
Zhao, Dongqin [1 ]
Xiong, Junjie [1 ]
Zou, Yu [1 ]
Huang, Guoquan [2 ]
Qian, Kun [1 ]
机构
[1] Chongqing Med Univ, Affiliated Hosp 1, Dept Gastrointestinal Surg, Chongqing 400016, Peoples R China
[2] Hubei Prov Key Lab Selenium Resources & Bioapplica, 158 Wuyang Ave, Enshi 445000, Hubei, Peoples R China
关键词
LOW ANTERIOR RESECTION; LOOP ILEOSTOMY; SURGERY; STOMA; COMPLICATIONS; MORBIDITY; ANASTOMOSIS; COLOSTOMY; SURVIVAL;
D O I
10.1155/2024/2410643
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background. Protective ileostomy can effectively prevent severe anastomotic leakage after rectal cancer surgery; however, the optimal timing for ileostomy closure during adjuvant chemotherapy remains unclear. This study aimed to explore the safety and long-term outcomes of early ileostomy closure during adjuvant chemotherapy. Method. Patients who underwent laparoscopic rectal cancer surgery combined with protective ileostomy and adjuvant chemotherapy between April 2017 and April 2021 were retrospectively evaluated. Patients were divided into an early closure group during chemotherapy (group A) and a late closure group after chemotherapy (group B). Results. A total of 215 patients were included in this study, with 115 in group A and 100 in group B. There were no significant differences in demographic and clinical characteristics between the two groups. In group A, durations of stoma status ( p < 0.001 ) and low anterior resection syndrome (LARS) ( p < 0.001 ) were shorter, and rectal stenosis ( p = 0.036 ) and stoma-related complications ( p = 0.007 ), especially stoma stenosis ( p = 0.041 ), were less common. However, compliance with chemotherapy was worse ( p = 0.009 ). There were no significant differences in operative time, postoperative hospital stay, postoperative complications, incidence and severity of LARS, disease-free survival, or overall survival between groups. Conclusion. Early ileostomy closure can effectively reduce the duration of stoma status, duration of LARS, rectal stenosis, and stoma-related complications while not affecting surgical complications and oncological outcomes. Ileostomy closure should not be delayed because of adjuvant chemotherapy. However, follow-up should be strengthened to increase compliance and integrity with chemotherapy.
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页数:11
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共 43 条
  • [1] Safe anastomosis in laparoscopic and robotic low anterior resection for rectal cancer: A narrative review and outcomes study from an expert tertiary center
    AL Asari, S.
    Cho, M. S.
    Kim, N. K.
    [J]. EJSO, 2015, 41 (02): : 175 - 185
  • [2] Long-term oncologic outcomes following anastomotic leak after anterior resection for rectal cancer: does the leak severity matter?
    Allaix, Marco Ettore
    Rebecchi, Fabrizio
    Famiglietti, Federico
    Arolf, Simone
    Arezzo, Alberto
    Morino, Mario
    [J]. SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2020, 34 (09): : 4166 - 4176
  • [3] The Role of Pelvic Floor Muscle Training on Low Anterior Resection Syndrome A Multicenter Randomized Controlled Trial
    Asnong, Anne
    D'Hoore, Andre
    Van Kampen, Marijke
    Wolthuis, Albert
    Van Molhem, Yves
    Van Geluwe, Bart
    Devoogdt, Nele
    De Groef, An
    Fajardo, Ipek Guler Caamano
    Geraerts, Inge
    [J]. ANNALS OF SURGERY, 2022, 276 (05) : 761 - 768
  • [4] Babayev H, 2021, TURK J COLORECTAL DI, V31, P116, DOI [10.4274/tjcd.galenos.2020.2020-9-10, DOI 10.4274/TJCD.GALENOS.2020.2020-9-10]
  • [5] The Incidence of Low Anterior Resection Syndrome as Assessed in an International Randomized Controlled Trial (MRC/NIHR ROLARR)
    Bolton, William S.
    Chapman, Stephen J.
    Corrigan, Neil
    Croft, Julie
    Collinson, Fiona
    Brown, Julia M.
    Jayne, David G.
    [J]. ANNALS OF SURGERY, 2021, 274 (06) : E1223 - E1229
  • [6] Living with a stoma: a review of the literature
    Brown, H
    Randle, J
    [J]. JOURNAL OF CLINICAL NURSING, 2005, 14 (01) : 74 - 81
  • [7] Incidence, consequences, and risk factors for anastomotic dehiscence after colorectal surgery: a prospective monocentric study
    Buchs, Nicolas C.
    Gervaz, Pascal
    Secic, Michelle
    Bucher, Pascal
    Mugnier-Konrad, Beatrice
    Morel, Philippe
    [J]. INTERNATIONAL JOURNAL OF COLORECTAL DISEASE, 2008, 23 (03) : 265 - 270
  • [8] Impact of chemotherapy on surgical outcomes in ileostomy reversal: a propensity score matching study from a single centre
    Cheng, H. -H.
    Shao, Y. -C.
    Lin, C. -Y.
    Chiang, T. -W.
    Chen, M. -C.
    Chiu, T. -Y.
    Huang, Y. -L.
    Chen, C. -C.
    Chen, C. -P.
    Chiang, F. -F.
    [J]. TECHNIQUES IN COLOPROCTOLOGY, 2023, 27 (12) : 1227 - 1234
  • [9] Clinical Outcomes of Ileostomy Closure According to Timing During Adjuvant Chemotherapy After Rectal Cancer Surgery
    Choi, Yoo Jin
    Kwak, Jung-Myun
    Ha, Neul
    Lee, Tae Hoon
    Baek, Se Jin
    Kim, Jin
    Kim, Seon Hahn
    [J]. ANNALS OF COLOPROCTOLOGY, 2019, 35 (04) : 187 - 193
  • [10] The morbidity surrounding reversal of defunctioning ileostomies: a systematic review of 48 studies including 6,107 cases
    Chow, Andre
    Tilney, Henry S.
    Paraskeva, Paraskevas
    Jeyarajah, Santhini
    Zacharakis, Emmanouil
    Purkayastha, Sanjay
    [J]. INTERNATIONAL JOURNAL OF COLORECTAL DISEASE, 2009, 24 (06) : 711 - 723