A meta-analysis of the role of diverting ileostomy after rectal cancer surgery

Ahmad, Nasir Zaheer; Abbas, Muhammad Hasan; Khan, Saad Ullah; Parvaiz, Amjad

doi:10.1007/s00384-020-03771-z

Cited by 57 publications

(38 citation statements)

References 35 publications

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“…In the 1990s and 2000s, it was reported that temporary stoma placement significantly prevented suture failure in low anterior resection. 13 , 14 , 15 , 16 , 17 , 18 Later, in the 2010s, the impact of temporary stoma construction on rates of complication other than suture failure was also examined. 14 Insurance coverage for stents beginning in 2012 has enabled preoperative decompression for colorectal cancer obstruction, decreased the rate of stoma construction before cancer chemotherapy, 19 and has reportedly prevented suture failure in transanal anal drains.…”

Section: Discussionmentioning

confidence: 99%

Survey Regarding Gastrointestinal Stoma Construction and Closure in Japan

Ando

Takahashi

Fujii

et al. 2021

Annals of Gastroent Surgery

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Section: Discussionmentioning

confidence: 99%

Survey Regarding Gastrointestinal Stoma Construction and Closure in Japan

Ando

Takahashi

Fujii

et al. 2021

Annals of Gastroent Surgery

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“…AL-driven pelvic sepsis and failure of healing by first intention may lead to granulation tissue formation and peri-anastomotic fibrosis, as well as anastomotic stricture and reduction of the neorectal reservoir function [ 3 , 4 ]. Routine diverting ileostomy as a common practice in all low rectal anastomoses seems to be supported by many surgeons although a recent meta-analysis from UK highlights the importance of other than anastomotic leak complications in the ileostomy group which should always be considered [ 31 ]. Same results are highlighted in the RALAR multicentre study from 24 Italian referral centers.…”

Section: Discussionmentioning

confidence: 99%

The effect of anastomotic leak on postoperative pelvic function and quality of life in rectal cancer patients

et al. 2022

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Aim The aim of this review was to collect all available literature data analysing the effects of the anastomotic leak (AL) on post-sphincter preserving rectal cancer surgery bowel and urogenital function as well as to quality of life (QoL) dimensions. Methods A literature search of the PubMed and Embase electronic databases was conducted by two independent investigators and all studies using either functional parameters or QoL as a primary or secondary endpoint after a rectal cancer surgery AL were included. Results Amongst the 13 identified studies focusing on the post-AL neorecto-anal function, 3 case-matched studies,3 comparative studies and 1 population-based study supported the deleterious effects of the AL on bowel function, with disturbances of the types of high bowel movement frequency, urgency and increased incontinent episodes to predominate. At one case-matched study the Low Anterior Resection Syndrome (LARS) score was inferior in the AL patients. At limited under-powered studies, urinary frequency, reduced male sexual activity and female dyspareunia may be linked to a prior AL. According to two QoL-targeted detailed studies, QoL disturbances, such as physical and emotional function difficulties may persist up to 3 years after the AL occurrence. Conclusions AL may have adverse effects on postoperative pelvic function and QoL in rectal cancer patients. As evidenced by this literature review, the limited reports on this intriguing topic may trigger the initiative for planning and undertaking larger, multicentre studies on rectal cancer patients with varying degrees of AL severity.

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“…After bowel resection, ostomy can be performed instead of primary anastomosis to prevent AL. Diverting ileostomy is one of the common choices with ostomy because it is believed that it can decrease the AL rate associated with colorectal cancer ( 11 ). The AL rate has not shown any difference with permanent ostomy and temporary ostomy for colorectal cancer ( 12 ).…”

Section: Introductionmentioning

confidence: 99%

Ostomy Does Not Lead to Worse Outcomes After Bowel Resection With Ovarian Cancer: A Systematic Review

2022

Front. Oncol.

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BackgroundDebulking cytoreduction surgery with bowel resection is a common intervention for ovarian cancer. It is controversial whether ostomy causes worse survival outcomes and how clinical physicians should choose which patients to undergo ostomy. During this study, we performed a systematic review to determine whether ostomy leads to worse outcomes after bowel resection compared to anastomosis. We also summarized the possible indications for ostomy. MethodsWe searched PubMed, Embase, and Cochrane for articles containing the phrase “ovarian cancer with bowel resection” that were published between 2016 and 2021. We included studies that compared primary anastomosis with ostomy. We mainly focused on differences in the anastomotic leakage rate, length of hospital stay, overall survival, and other survival outcomes associated with the two procedures.Results and ConclusionOf the 763 studies, three were ultimately included in the systematic review (N=1411). We found that ostomy did not contribute to worse survival outcomes, and that the stoma-related complications were acceptable. Indications for ostomy require further study. Bowel resection segment margins and the distance from the anastomosis to the anal verge require consideration.

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A meta-analysis of the role of diverting ileostomy after rectal cancer surgery

Cited by 57 publications

References 35 publications

Survey Regarding Gastrointestinal Stoma Construction and Closure in Japan

Survey Regarding Gastrointestinal Stoma Construction and Closure in Japan

The effect of anastomotic leak on postoperative pelvic function and quality of life in rectal cancer patients

Ostomy Does Not Lead to Worse Outcomes After Bowel Resection With Ovarian Cancer: A Systematic Review

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