Impact of chemotherapy on surgical outcomes in ileostomy reversal: a propensity score matching study from a single centre

Cheng, Hui; Shao, Y.-C.; Lin, Chih‐Ming; Chiang, T.-W.; Chen, M.-C.; Chiu, T.-Y.; Huang, Yu-Wen; Chen, C.-C.; Chen, C.-P.; Chiang, F.-F.

doi:10.1007/s10151-023-02790-6

Cited by 3 publications

(1 citation statement)

References 32 publications

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“…However, Choi et al [ 26 ] believe that ileostomy closure during chemotherapy is clinically safe and that chemotherapy interruption due to ileostomy reduction does not alter oncological outcomes. Cheng et al [ 27 ] came to the same conclusion, suggesting no increase in surgical complications among patients who received chemotherapy after rectal cancer surgery. In this study, we also reached the same point of view, and no significant difference was observed between the two groups of patients in terms of postoperative complications, which proves the safety and feasibility of undergoing reductive surgery during chemotherapy.…”

Section: Discussionmentioning

confidence: 73%

Clinical Outcomes of Ileostomy Closure during versus after Adjuvant Chemotherapy in Patients with Rectal Cancer

He,

Yang,

Tang

et al. 2024

Canadian Journal of Gastroenterology and Hepatology

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Background. Protective ileostomy can effectively prevent severe anastomotic leakage after rectal cancer surgery; however, the optimal timing for ileostomy closure during adjuvant chemotherapy remains unclear. This study aimed to explore the safety and long-term outcomes of early ileostomy closure during adjuvant chemotherapy. Method. Patients who underwent laparoscopic rectal cancer surgery combined with protective ileostomy and adjuvant chemotherapy between April 2017 and April 2021 were retrospectively evaluated. Patients were divided into an early closure group during chemotherapy (group A) and a late closure group after chemotherapy (group B). Results. A total of 215 patients were included in this study, with 115 in group A and 100 in group B. There were no significant differences in demographic and clinical characteristics between the two groups. In group A, durations of stoma status (p<0.001) and low anterior resection syndrome (LARS) (p<0.001) were shorter, and rectal stenosis (p=0.036) and stoma-related complications (p=0.007), especially stoma stenosis (p=0.041), were less common. However, compliance with chemotherapy was worse (p=0.009). There were no significant differences in operative time, postoperative hospital stay, postoperative complications, incidence and severity of LARS, disease-free survival, or overall survival between groups. Conclusion. Early ileostomy closure can effectively reduce the duration of stoma status, duration of LARS, rectal stenosis, and stoma-related complications while not affecting surgical complications and oncological outcomes. Ileostomy closure should not be delayed because of adjuvant chemotherapy. However, follow-up should be strengthened to increase compliance and integrity with chemotherapy.

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Section: Discussionmentioning

confidence: 73%

Clinical Outcomes of Ileostomy Closure during versus after Adjuvant Chemotherapy in Patients with Rectal Cancer

He,

Yang,

Tang

et al. 2024

Canadian Journal of Gastroenterology and Hepatology

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Impact of neoadjuvant immunotherapy on postoperative complications after surgery for rectal cancer

Shou,

Habib,

Idrees

et al. 2024

Journal of Surgical Oncology

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IntroductionDespite the increasing use of immunotherapy in treating various cancer types, there is still limited understanding of its impact on surgical complications. We used a national database to examine the difference in surgical outcomes for rectal cancer patients who received standard neoadjuvant chemoradiation plus neoadjuvant immunotherapy and patients who received neoadjuvant chemoradiation only.MethodsThis retrospective cohort study used the National Cancer Database (NCDB). We selected patients aged 18–90 with T1‐3, N1‐2, and M0 rectal cancer who underwent curative‐intent surgery between 2010 and 2020. We performed a 1:1 propensity match to control for patient age, sex, Charlson–Deyo comorbidity index, surgical approach, and tumor site. Our primary outcome was difference in surgical outcomes (hospital length of stay, unplanned 30‐day readmission, 30‐day mortality) between the two groups. Secondary outcomes included days from diagnosis to surgery and pathologic outcomes.ResultsOur study included 26 229 patients, of which 126 received immunotherapy in addition to chemoradiation and 26 103 received only chemoradiation. In our matched population of 125 pairs of patients, patients who received immunotherapy and chemoradiation underwent surgery later compared to patients who only received chemoradiation (median 245 vs. 144 days, p < 0.001). There were no significant differences in median length of stay (5 vs. 5 days, p = 0.202), unplanned 30‐day readmission (7 vs. 9, p = 0.617), and 30‐day mortality (0 vs. 1, p = 1.000) between the two groups.ConclusionNeoadjuvant immunotherapy for rectal cancer is not associated with adverse surgical outcomes. This work can help clinicians optimize treatment protocols and move closer toward strategies tailored to specific patient profiles.

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Early diverting stoma closure is feasible and safe: results from a before-and-after study on the implementation of an early closure protocol at a tertiary referral center

Blanco Terés,

Cerdán Santacruz,

Correa Bonito

et al. 2024

Tech Coloproctol

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Impact of chemotherapy on surgical outcomes in ileostomy reversal: a propensity score matching study from a single centre

Cited by 3 publications

References 32 publications

Clinical Outcomes of Ileostomy Closure during versus after Adjuvant Chemotherapy in Patients with Rectal Cancer

Clinical Outcomes of Ileostomy Closure during versus after Adjuvant Chemotherapy in Patients with Rectal Cancer

Impact of neoadjuvant immunotherapy on postoperative complications after surgery for rectal cancer

Early diverting stoma closure is feasible and safe: results from a before-and-after study on the implementation of an early closure protocol at a tertiary referral center

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