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UNREVERSED STOMAS IN RECTAL CANCER
Author(s) -
Mishra S.,
Jones I. T.,
Gibbs P.,
Shedda S.
Publication year - 2009
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2009.04915_36.x
Subject(s) - medicine , anastomosis , colorectal cancer , surgery , stoma (medicine) , colostomy , retrospective cohort study , cancer , general surgery
Purpose: Approximately 10% of temporary stomas created after low or ultra low anterior resection for rectal cancer remain unreversed. In this study, we aim to determine the reversal rate at our institution and the reasons for stomas remaining unreversed, especially due to anastomotic leaks. Method: A retrospective study of patients who underwent surgery for rectal cancer at a single institution between 1st January 2003 and 31st December 2007 was performed. Patients with unreversed stomas were identified and their patient files reviewed. Results: 230 patients who underwent surgery for rectal cancer were considered. 54 of these had low or ultra‐low anterior resection and a stoma fashioned. 47 (87%) had their stomas reversed (RS), and 7 (13%) had not (US). The RS group were younger, with 30 (63%) males compared to 6 (86%) in the US group. Not surprisingly, the US group were more likely to have surgical complications (72% vs. 28%, p = 0.022). The reasons for non‐reversal were anastomotic leak 2(28%), death 2(28%), metastatic disease 1(14%), medical co‐morbidities 1 (14%), and patient refusal 1 (14%). Of the 2 patients with anastomotic leaks, 1 remained unreversed due to development of stricture at the point of anastomosis, while the other was reversed 8 months later (outside the study period). Conclusion: When faecal diversion surgery is undertaken in low or ultra low anterior resection for the treatment of rectal cancer, it is usually reversed during a reasonable period of time. Surprisingly, even in our very small set of patients (7) with unreversed stomas, only 2 were unreversed due to anastomotic leaks.