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Scand J Surg. 2013;102(4):246-50. doi: 10.1177/1457496913489086. Epub 2013 Sep 20.

When are defunctioning stomas in rectal cancer surgery really reversed? Results from a population-based single center experience.

Author information

1
Department of Surgery, Örebro University Hospital, Örebro, Sweden.

Abstract

BACKGROUND AND AIMS:

This study assessed the timing of reversal of defunctioning stoma following low anterior resection of the rectum for cancer and risk factors for a defunctioning stoma becoming permanent in patients who were not reversed.

MATERIAL AND METHODS:

Patients who underwent low anterior resection with defunctioning stoma during a 12-year period were assessed with regard to timing of stoma reversal. Delayed reversal was defined as >4 months after low anterior resection. Patients with a defunctioning stoma that was never reversed were assessed regarding risk factors for permanent stoma.

RESULTS:

A total of 134 patients were analyzed. Of 106 stoma reversals, 19% were reversed within 4 months of low anterior resection, while 81% were reversed later than 4 months. In 58% of these patients, the delay was to due to low medical priority given to this procedure. The other main reasons for delayed stoma reversal were nonsurgical complications (20%), symptomatic anastomotic leakage following low anterior resection (12%), and postoperative adjuvant chemotherapy (10%). Of all patients, 21% (28/134) ended up with a permanent stoma. Risk factors for a defunctioning stoma becoming permanent were stage IV cancer (P < 0.001) and symptomatic anastomotic leakage following low anterior resection (P < 0.001).

CONCLUSION:

Four in five patients experienced a delayed stoma reversal, in a majority because of the low priority given to this surgical procedure.

KEYWORDS:

Rectal cancer; defunctioning stoma; low anterior resection of the rectum; permanent stoma; risk factors; stoma reversal; temporary stoma

PMID:
24056133
DOI:
10.1177/1457496913489086
[Indexed for MEDLINE]

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