Cumulative Incidence of Permanent Stoma After Sphincter Preserving Low Anterior Resection of Mid and Low Rectal Cancer

Low anterior resection combined with a covering stoma in the treatment of rectal cancer reduces the risk of permanent anastomotic failure

“…In a multicenter follow-up trial in Sweden, 57.8 % of patients not having an initial defunctioning stoma ended up with permanent stomas [12]. Accordingly, in a study reporting a permanent stoma rate of 12.0 %, which is comparable with our results, an 18.5 % permanent stoma rate was established for those patients not primarily diverted [5]. In a study from South Korea with excellent results, a diverting stoma diminished the risk of a permanent stoma [9,16].…”

“…In most of the other studies concerning risk factors for permanent stomas, fistulas were included in the leakage rate making comparison between the studies difficult [12,15,21]. As in other studies published, anastomotic leakage and tumor recurrence were also risk factors for permanent stomas in our series [5,[14][15][16]21]. In our study, in contrast to the results of Seo and his coworkers [16], neither preoperative radiotherapy nor male gender was risk factors for a permanent stoma.…”

“…It is well known that low colorectal and coloanal anastomoses are associated with a higher incidence of anastomosisrelated complications, the rate varying between 2 and 24 %, depending on how a complication is defined [5][6][7][8][9][10][11]. Accordingly, the risk reported for a permanent stoma has varied between 3 and 29 % [10][11][12][13] and the risk that a defunctioning stoma becomes a permanent one has been described as varying between 3 and 19 % [8,[14][15][16].…”

Einfluss der Anastomoseninsuffizienz auf das Langzeitüberleben beim tiefen Rektumkarzinom

“…Studienkohorte Aus der klinikeigenen, prospektiv angelegten und auditfähigen Datenbank "Kolorektales Karzinom" der Universitätskli-nik für Chirurgie der Paracelsus Medizinischen Privatuniversität in Salzburg (Österreich) wurden in einem Zeitraum von Januar 2003 bis Oktober 2010 insgesamt 303 Patienten mit einem Rektumkarzinom identifiziert [21]. Für die vorliegende Studie wurden alle sphinktererhaltend operierten Patienten mit einem histologisch gesicherten Adenokarzinom des mittleren und unteren Rektumdrittels im Tumorstadium UICC (y) 0-III (n = 108) mit konsekutiver standardisierter histopathologischer Aufarbeitung untersucht (.…”

Surgeon perspectives on the use and effects of neoadjuvant chemoradiation in the treatment of rectal cancer: a comprehensive review of the literature

“…This post-operative complication represents one of the most concerning potential morbidities that occur in this patient population for a variety of reasons including poorer gastrointestinal function and quality of life [53,54], increased rate of recurrence [55,56], and decreased frequency of ultimate sphincter preservation [57].…”