Yonsei Med J.  2015 Mar;56(2):447-453. 10.3349/ymj.2015.56.2.447.

Risk Factors of Permanent Stomas in Patients with Rectal Cancer after Low Anterior Resection with Temporary Stomas

• Lee CM
• Huh JW
• Park YA
• Cho YB
• Kim HC
• Yun SH
• Lee WY
• Chun HK

• KMID: 2070023
• DOI: http://doi.org/10.3349/ymj.2015.56.2.447

Abstract

PURPOSE
The aim of this study was to identify risk factors influencing permanent stomas after low anterior resection with temporary stomas for rectal cancer.
MATERIALS AND METHODS
A total of 2528 consecutive rectal cancer patients who had undergone low anterior resection were retrospectively reviewed. Risk factors for permanent stomas were evaluated among these patients.
RESULTS
Among 2528 cases of rectal cancer, a total of 231 patients had a temporary diverting stoma. Among these cases, 217 (93.9%) received a stoma reversal. The median period between primary surgery and stoma reversal was 7.5 months. The temporary and permanent stoma groups consisted of 203 and 28 patients, respectively. Multivariate analysis showed that independent risk factors for permanent stomas were anastomotic-related complications (p=0.001) and local recurrence (p=0.001). The 5-year overall survival for the temporary and permanent stoma groups were 87.0% and 70.5%, respectively (p<0.001).
CONCLUSION
Rectal cancer patients who have temporary stomas after low anterior resection with local recurrence and anastomotic-related complications may be at increased risk for permanent stoma.

Keyword

Stoma; rectal cancer; low anterior resection

MeSH Terms

Adenocarcinoma/pathology/*surgery
Adult
Aged
Aged, 80 and over
Female
Follow-Up Studies
Humans
Ileostomy/*statistics & numerical data
Incidence
Male
Middle Aged
Multivariate Analysis
Neoplasm Recurrence, Local
Postoperative Complications/epidemiology
Rectal Neoplasms/pathology/*surgery
Republic of Korea/epidemiology
Retrospective Studies
Risk Factors
Surgical Stomas/*statistics & numerical data
Treatment Outcome

Figure

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  Fig. 1 Patient selection flow chart. LAR, low anterior resection; APR, abdominoperineal resection.

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  Fig. 2 Kaplan-Meier curves of 231 patients with temporary stomas. (A) Disease-free survival. (B) Overall survival.

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