Early Laparoscopic Ileostomy Reversal After Rectal Cancer Surgery - Technique and Outcomes

Copăescu, C; Smeu, Bogdan; Catanescu, Elena; Andrei, Dan; Tomulescu, Victor

doi:10.21614/chirurgia.114.3.392

Cited by 4 publications

(2 citation statements)

References 14 publications

(25 reference statements)

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“…12 An increasing number of studies investigated very early stoma reversal; one study even reported successful bowel continuity restoration only after 3 weeks, albeit in a small sample. 36 Another meta-analysis reported comparable outcomes of ileostomy reversal within 2 weeks. 37 A recent randomized controlled trial with a large sample investigated the difference between 2 and 12 weeks.…”

Section: Discussionmentioning

confidence: 99%

The Effect of a Temporary Stoma on Long-term Functional Outcomes Following Surgery for Rectal Cancer

Verkuijl,

Jonker,

Furnée

et al. 2023

Diseases of the Colon &Amp; Rectum

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BACKGROUND: Patients with rectal cancer may undergo surgical resection with or without a temporary stoma. OBJECTIVE: This study primary aimed to compare long-term functional outcomes between patients with and without a temporary stoma following surgery for rectal cancer. The secondary aim was to investigate the effect of time to stoma reversal on functional outcomes. DESIGN: This was a multicenter, cross-sectional study. SETTINGS: This study was conducted at seven Dutch hospitals. PATIENTS: Included were patients who had undergone rectal cancer surgery (2009-2015). Excluded were deceased patients, patients with a permanent stoma, or intellectual disability. MAIN OUTCOME MEASURES: Functional outcomes were measured using the Rome IV criteria for constipation and fecal incontinence and the low anterior resection syndrome (LARS) score. RESULTS: Out of 656 patients, 32% received a temporary ileostomy and 20% a temporary colostomy (86% response). Follow-up was at 56.0 (IQR 38.5-79.0) months. Patients who had a temporary ileostomy experienced less constipation, more fecal incontinence, and more major low anterior resection syndrome, than patients without a temporary stoma. Patients who had a temporary colostomy experienced more major low anterior resection syndrome than patients without a temporary stoma. A temporary ileostomy or colostomy was not associated with constipation or fecal incontinence following correction for confounding factors (e.g., anastomotic height, anastomotic leakage, radiotherapy). Time to stoma reversal was not associated with constipation, fecal incontinence, or major low anterior resection syndrome. LIMITATIONS: The current study is limited by its cross-sectional design. CONCLUSIONS: Although patients with a temporary ileostomy or colostomy have worse functional outcomes in the long term, it seems that the reason for creating a temporary stoma, rather than the stoma itself, underlies this phenomenon. Time to reversal of a temporary stoma does not influence functional outcomes

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Section: Discussionmentioning

confidence: 99%

The Effect of a Temporary Stoma on Long-term Functional Outcomes Following Surgery for Rectal Cancer

Verkuijl,

Jonker,

Furnée

et al. 2023

Diseases of the Colon &Amp; Rectum

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“…As minimally invasive techniques evolved, laparoscope has been increasingly applied to colorectal operations. For instance, some researchers have shown the laparoscopic reversal was associated with rapid postoperative recovery, reduced morbidity and lower cost compared to open approach (7,8). Satisfactory outcomes were also reported in patients with Crohn's disease and obesity (9,10).…”

Section: Introductionmentioning

confidence: 99%

Satisfactory short-term outcomes of totally laparoscopic ileostomy reversal compared to open surgery in colorectal cancer patients

Zheng

Luo

et al. 2023

Front. Surg.

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BackgroundRecently, totally laparoscopic (TLAP) surgery has suggested its potential on ileostomy reversal. This study aimed to compare the short-term outcomes between TLAP and traditional open ileostomy reversal.Patients and methodsFrom September 2016 to September 2021, 107 eligible patients underwent TLAP (n = 48) or open (n = 59) loop ileostomy reversal were retrospectively enrolled. Surgical parameters, postoperative recovery and complications were identified and compared between TLAP technique vs. open surgery.ResultsThe operation time and estimated blood loss showed no obvious difference between TLAP and open group. However, TLAP reversal significantly decreased the incision length (4.5cm vs. 6cm, P < 0.001). Furthermore, patients underwent TLAP surgery showed quicker first ground activities (1 day vs. 2 days, P < 0.001), faster first flatus passage (2 days vs. 3 days, P = 0.004) and shorter postoperative stay (5 days vs. 7 days, P = 0.007). More importantly, postoperative complications were significantly reduced after TLAP reversal (3 cases vs. 10 cases, P = 0.026). Further logistic regression analyses also indicated the TLAP technique was associated with lower incidence of complications (OR=3.316, CI, 1.118–9.835; P = 0.031).ConclusionsTLAP surgery is competitive in promoting postoperative recovery as well as reducing complications compared to the traditional open ileostomy reversal.

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Early closure compared to late closure of temporary ileostomy in rectal cancer: a randomized controlled trial study

Ahmadi-Amoli,

Rahimi,

Abedi-kichi

et al. 2023

Langenbecks Arch Surg

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A temporary loop ileostomy is one of the most common methods for the prevention of anastomotic leakage in rectal cancer patients who underwent low anterior resection. However, the optimal timing of loop ileostomy reversal remains unknown. The main purpose of this study is to assess the suitable time for a reversal of temporary loop ileostomy in rectal cancer patients. MethodsWe conducted a prospective, randomized trial at Sina Hospital, Tehran, Iran from 2020 to 2021 to determine the appropriate time for closure of temporary loop ileostomy in rectal cancer patients who underwent low anterior resection. ResultsThe results of this prospective randomized controlled trial are as shown: signi cantly difference in body mass index, the time interval between creation and closure of stoma, and distance from last chemotherapy. No signi cant difference was found between the two groups in terms of complications based on the Clavien-Dindo classi cation. As well as, there is no signi cant difference in perioperative outcomes, such as blood loss, operative time, re-admission, and re-operation. Also, statistically signi cant differences had reported between patients' quality of life and LARS score. ConclusionIn summary, it seems that early closure of ileostomy is generally effective and safe in reducing the risk of complications and improving quality of life in patients with rectal cancer following low anterior resection and chemotherapy (neoadjuvant and adjuvant).

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Early Laparoscopic Ileostomy Reversal After Rectal Cancer Surgery - Technique and Outcomes

Cited by 4 publications

References 14 publications

The Effect of a Temporary Stoma on Long-term Functional Outcomes Following Surgery for Rectal Cancer

The Effect of a Temporary Stoma on Long-term Functional Outcomes Following Surgery for Rectal Cancer

Satisfactory short-term outcomes of totally laparoscopic ileostomy reversal compared to open surgery in colorectal cancer patients

Early closure compared to late closure of temporary ileostomy in rectal cancer: a randomized controlled trial study

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