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01-12-2023 | Enterostomy | Research

Comparison of clinical outcomes of stoma reversal during versus after chemotherapy for rectal cancer patients

Authors: Kun-Yu Tsai, Jeng-Fu You, Shu-Huan Huang, Tzong-yun Tsai, Pao-Shiu Hsieh, Cheng-Chou Lai, Wen-Sy Tsai, Hsin-Yuan Hung

Published in: Langenbeck's Archives of Surgery | Issue 1/2023

Abstract

Purpose

The optimal timing of stoma closure during or after adjuvant chemotherapy for rectal cancer patients undergoing sphincter-preserving surgery remains unknown. This study aimed to investigate the influence of clinical and oncological outcomes depending on the timing of stoma closure.

Methods

Between January 2006 and December 2015, we enrolled 244 consecutive rectal cancer patients who underwent curative-intent sphincter-preserving surgery with diverting transverse colostomy and adjuvant chemotherapy. Patients with stoma closure during (During group) adjuvant chemotherapy were compared to those who had stoma closure after adjuvant chemotherapy (After group).

Results

Parastomal hernia occurred more frequently in the after group than in the during group. (10% vs. 2.9%, p = 0.028). Overall, no significant difference was observed in overall survival (OS) or disease-free survival (DFS) between the two groups (p = 0.911 for OS, p = 0.505 for DFS). However, an inferior OS occurred if reopen surgery was performed within 30 days of stoma closure in the during group, as compared with the after group (p = 0.004). In addition, a marginally poor DFS was observed in the group of patients who received further operations due to 30-day stoma closure complications compared to the other patients (p = 0.07).

Conclusions

For rectal cancer patients who underwent sphincter-preserving surgery, attention should be given to avoid 30-day major complications after stoma reversal because patients who require reoperation during adjuvant chemotherapy may have poor long-term survival.

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Title: Comparison of clinical outcomes of stoma reversal during versus after chemotherapy for rectal cancer patients
Authors: Kun-Yu Tsai
Jeng-Fu You
Shu-Huan Huang
Tzong-yun Tsai
Pao-Shiu Hsieh
Cheng-Chou Lai
Wen-Sy Tsai
Hsin-Yuan Hung
Publication date: 01-12-2023
Publisher: Springer Berlin Heidelberg
Keywords: Enterostomy
Enterostomy
Rectal Cancer
Rectal Cancer
Ileostomy
Colostomy
Cytostatic Therapy
Parastomale Hernie
Published in: Langenbeck's Archives of Surgery / Issue 1/2023
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-023-03014-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Comparison of clinical outcomes of stoma reversal during versus after chemotherapy for rectal cancer patients

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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