Clinical assessment for non-reversal stoma and stoma re-creation after reversal surgery for rectal cancer patients after sphincter-saving operation

Chih Yu Kuo, Yen Kuang Lin, Po Li Wei, James Chi-Yong Ngu, Kuan Der Lee, Chi Long Chen, Yaoru Huang, Chia Che Chen, Li Jen Kuo

Research output: Contribution to journalArticlepeer-review

Abstract

Background: This study aimed to identify the risk factors for permanent stoma (PS) in patients who underwent sphincter-saving operations for rectal cancer. Methods: We retrospectively reviewed 597 consecutive patients with rectal cancer from January 2012 to December 2020 at Taipei Medical University Hospital. Univariate and multivariable analyses were used to analyze risk factors for PS. Results: After a mean follow-up of 47.3 months (range 7–114 months), 59 patients (15.1%) were alive with a PS, including 46 patients who did not undergo reversal surgery and 13 patients who underwent stoma re-creation after reversal surgery. The mean period between primary surgery and stoma reversal was 6.0 months. Multivariate analysis revealed that the risk factors for PS were local recurrence [odd ratio (OR), 25.58; 95% confidence interval (CI), 4.428–147.761; p < 0.001], perirectal abscess [OR, 154.34; 95% CI, 15.806 - >999; p < 0.001], anastomosis site stenosis [OR, 187.081; 95% CI, 22.193 - >999; p < 0.001], perineural invasion [OR, 4.782; 95% CI, 1.22–18.736; p = 0.025], and operation time (min) [OR, 1.008; 95% CI, 1.002–1.014; p = 0.01]. Conclusions: Local recurrence, perirectal abscess, anastomosis site stenosis, perineural invasion, and operation time were independent risk factors for PS. Therefore, before a patient undergoes surgery for rectal cancer, surgeons should consider the possibility of the need for a PS, and patients should be informed before the operation that closure of the temporary stoma may not always be possible.

Original languageEnglish
Pages (from-to)1944-1950
Number of pages7
JournalAsian Journal of Surgery
Volume46
Issue number5
DOIs
Publication statusAccepted/In press - 2022

Keywords

  • Permanent stoma
  • Rectal cancer
  • Reversal surgery
  • Sphincter saving

ASJC Scopus subject areas

  • Surgery

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