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Current use of dive...
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Rutegård, MartinUmeå universitet,Kirurgi
(author)
Current use of diverting stoma in anterior resection for cancer : population-based cohort study of total and partial mesorectal excision
- Article/chapterEnglish2016
Publisher, publication year, extent ...
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2015-12-15
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Springer Science and Business Media LLC,2016
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printrdacarrier
Numbers
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LIBRIS-ID:oai:DiVA.org:umu-118987
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https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-118987URI
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https://doi.org/10.1007/s00384-015-2465-6DOI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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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.
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Added entries (persons, corporate bodies, meetings, titles ...)
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Boström, PetrusUmeå universitet,Kirurgi(Swepub:umu)pebo0022
(author)
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Haapamäki, MarkkuUmeå universitet,Kirurgi(Swepub:umu)maha0047
(author)
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Matthiessen, Peter
(author)
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Rutegård, JörgenUmeå universitet,Kirurgi(Swepub:umu)jaru0001
(author)
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Umeå universitetKirurgi
(creator_code:org_t)
Related titles
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In:International Journal of Colorectal Disease: Springer Science and Business Media LLC31:3, s. 579-5850179-19581432-1262
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