Ann Surg Treat Res.  2018 Apr;94(4):203-208. 10.4174/astr.2018.94.4.203.

Risk factors of stoma re-creation after closure of diverting ileostomy in patients with rectal cancer who underwent low anterior resection or intersphincteric resection with loop ileostomy

• Song O
• Kim KH
• Lee SY
• Kim CH
• Kim YJ
• Kim HR

• KMID: 2407750
• DOI: http://doi.org/10.4174/astr.2018.94.4.203

Abstract

PURPOSE
The aim of this study was to identify the risk factors of stoma re-creation after closure of diverting ileostomy in patients with rectal cancer who underwent low anterior resection (LAR) or intersphincteric resection (ISR) with loop ileostomy.
METHODS
We retrospectively reviewed 520 consecutive patients with rectal cancer who underwent LAR or ISR with loop ileostomy from January 2005 to December 2014 at Chonnam National University Hwasun Hospital. Risk factors for stoma re-creation after ileostomy closure were evaluated.
RESULTS
Among 520 patients with rectal cancer who underwent LAR or ISR with loop ileostomy, 458 patients underwent stoma closure. Among these patients, 45 (9.8%) underwent stoma re-creation. The median period between primary surgery and stoma closure was 5.5 months (range, 0.5-78.3 months), and the median period between closure and re-creation was 6.8 months (range, 0-71.5 months). Stoma re-creation was performed because of anastomosis-related complications (26, 57.8%), local recurrence (15, 33.3%), and anal sphincter dysfunction (3, 6.7%). Multivariate analysis showed that independent risk factors for stoma re-creation were anastomotic leakage (odds ratio [OR], 4.258; 95% confidence interval [CI], 1.814-9.993), postoperative radiotherapy (OR, 3.947; 95% CI, 1.624-9.594), and ISR (OR, 3.293; 95% CI, 1.462-7.417).
CONCLUSION
Anastomotic leakage, postoperative radiotherapy, and ISR were independent risk factors for stoma re-creation after closure of ileostomy in patients with rectal cancer.

Keyword

Rectal neoplasms; Ileostomy; Operative surgical procedures

MeSH Terms

Anal Canal
Anastomotic Leak
Humans
Ileostomy*
Jeollanam-do
Multivariate Analysis
Radiotherapy
Rectal Neoplasms*
Recurrence
Retrospective Studies
Risk Factors*
Surgical Procedures, Operative

Figure

• 

  Fig. 1 Patient selection flow chart. LAR, low anterior resection; ISR, intersphincteric resection.

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