Do older Americans undergo stoma reversal following low anterior resection for rectal cancer?

Abstract

Objective-For low-lying rectal cancers, proximal diversion can reduce anastomotic leak after sphincter preserving surgery; however, evidence suggests that such temporary diversions are often not reversed. We aimed to evaluate non-reversal and delayed stoma reversal in elderly patients undergoing low anterior resection (LAR). The authors report no conflict of interest. Design-SEER-MedicareAuthor Contributions: Dodgion -study design, analysis and interpretation of data, manuscript preparation. Neville -acquisition of data, manuscript preparation. Lipsitz -study design, analysis and interpretation of data, manuscript preparation. Schrag -study design, interpretation of data, manuscript preparation. Breen -study design, interpretation of data, manuscript preparation. Greenberg -study design, analysis and interpretation of data, manuscript preparation and project oversight.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access

Determinants of stoma reversal in rectal cancer patients who had an anterior resection between 2009 and 2012 in the English National Health Service

“… may not be in keeping with current practice. The present findings reinforce those reported previously, with older age , presence of comorbidity , more advanced stage disease , lower socioeconomic status and open surgery being identified as factors linked to lower stoma reversal rates. This study is the first to report lower reversal rates in patients with poor physical fitness.…”

Does ghost ileostomy have a role in the laparoscopic rectal surgery era? A randomized controlled trial

“…Furthermore of the patients who have undergone anterior rectal resection with a temporary stoma a percentage from 6 and 20 % will not undergo stoma reversal [36,37]. This percentage increases to 50 % if we consider only the elderly patients [39].…”

Fatores associados a não reconstrução do trânsito intestinal em pacientes com câncer retal submetidos à ressecção anterior do reto e ileostomia de proteção.

“…The periods described for restoration of bowel continuity after rectal cancer treatment vary between four and 12 months 7,9,11,12,20,25 . Factors related to the delay in the reconstruction of intestinal transit are adjuvant chemotherapy, elderly patients, advanced stages of neoplasia and presence of comorbidities 5,20,24 . (Table 4).…”

“…In the present study, 32.6% of the patients did not have the protective ileostomy closed after ARR. The reported prevalence of stomatal permanence after colorectal resections varies between 12% and 43% 4,5,9,11,15,20,22,24 .…”

“…The anastomotic fistula after ARR factor is recognized as related to the non-closure of the ileostomy 5,9,16,17,20,25…”