Ann Coloproctol.  2019 Aug;35(4):187-193. 10.3393/ac.2018.10.18.1.

Clinical Outcomes of Ileostomy Closure According to Timing During Adjuvant Chemotherapy After Rectal Cancer Surgery

• Choi YJ
• Kwak JM
• Ha N
• Lee TH
• Baek SJ
• Kim J
• Kim SH

• KMID: 2457711
• DOI: http://doi.org/10.3393/ac.2018.10.18.1

Abstract

PURPOSE
No guidelines exist detailing when to implement a temporary ileostomy closure in the setting of adjuvant chemotherapy following sphincter-saving surgery for rectal cancer. The aim of this study was to evaluate the clinical and oncological outcomes of ileostomy closure during adjuvant chemotherapy in patients with curative resection of rectal cancer.
METHODS
This retrospective study investigated 220 patients with rectal cancer undergoing sphincter-saving surgery with protective loop ileostomy from January 2007 to August 2016. Patients were divided into 2 groups: group 1 (n = 161) who underwent stoma closure during adjuvant chemotherapy and group 2 (n = 59) who underwent stoma closure after adjuvant chemotherapy.
RESULTS
No significant differences were observed in operative time, blood loss, postoperative hospital stay, or postoperative complications in ileostomy closure between the 2 groups. No difference in overall survival (P = 0.959) or disease-free survival (P = 0.114) was observed between the 2 groups.
CONCLUSION
Ileostomy closure during adjuvant chemotherapy was clinically safe, and interruption of chemotherapy due to ileostomy closure did not change oncologic outcomes.

Keyword

Rectal neoplasms; Ileostomy; Adjuvant chemotherapy

MeSH Terms

Chemotherapy, Adjuvant*
Disease-Free Survival
Drug Therapy
Humans
Ileostomy*
Length of Stay
Operative Time
Postoperative Complications
Postoperative Hemorrhage
Rectal Neoplasms*
Retrospective Studies