Loop ileostomy or loop transverse colostomy for resectable rectal cancers

Authors : Mehmet Ali ÇAPARLAR, Şeref DOKÇU, Salim DEMİRCİ

Pages : 340-346

Doi:10.18621/eurj.914951

View : 19 | Download : 10

Publication Date : 2022-05-04

Article Type : Research Paper

Abstract :Objectives: This retrospective study aimed to compare loop ileostomy insert ignore into journalissuearticles values(LI); with loop transverse colostomy insert ignore into journalissuearticles values(LTC); as covering stoma regarding the perioperative outcomes in patients who underwent low anterior resection for rectal cancer between 2015 and 2020. Methods: Data were collected from patient files and the hospital`s electronic database. The primary outcome measure was complications related to stoma formation, stoma reversal, and overall complications. Secondary outcome measures were hospital discharge time and readmission rate after discharge. Results: A total of 90 patients insert ignore into journalissuearticles values(38 female, 52 male; 56.6 ± 6.8 years); were included in the study. There were two groups considering the technique for covering stoma: Group LI insert ignore into journalissuearticles values(n = 50); and Group LTC insert ignore into journalissuearticles values(n = 40);. Demographic and perioperative characteristics were similar. Primary outcome measure: Postoperative course was complicated in 49 insert ignore into journalissuearticles values(54.4%); patients. The complication rate was higher in the group LI than the group LTC insert ignore into journalissuearticles values(62% vs 45%; p = 0.03);. Among them, 29 insert ignore into journalissuearticles values(59.2%); complications were related to the stoma formation related, and 14 insert ignore into journalissuearticles values(28.6 %); complications were related to the stoma reversal related, and 6 insert ignore into journalissuearticles values(12.2%); were overall complications. The rate of complications related to the stoma formation was higher in the group LI compared to the group LTC insert ignore into journalissuearticles values(20 [40%] vs. 9 [22.5%]; p = 0.01);. The most common complication was periostomal skin irritation insert ignore into journalissuearticles values(48.3%); followed by dehydration insert ignore into journalissuearticles values(13.8%);, stoma retraction insert ignore into journalissuearticles values(10.3%); patients, parastomal hernia insert ignore into journalissuearticles values(10.3%);, bleeding insert ignore into journalissuearticles values(6.9%);, anastomotic leak insert ignore into journalissuearticles values(3.4%);, incisional hernia insert ignore into journalissuearticles values(3.4%);, and high-output stoma insert ignore into journalissuearticles values(3.4%);. Complications including incisional hernia, high output stoma, and anastomotic leakage insert ignore into journalissuearticles values(Grade C; requiring laparotomy); were observed only in the group LI. The morbidity rate in 30 days after the surgery was higher in the group LI compared to the group LTC insert ignore into journalissuearticles values(16 [32%] vs. 8 [20%]; p = 0.02);. A total of 14 stoma reversal complications included incisional hernia in 7 insert ignore into journalissuearticles values(14.3%); patients, wound infection in 5 insert ignore into journalissuearticles values(10.2%); patients, and rectal bleeding in 2 insert ignore into journalissuearticles values(4.1%); patients. The rate of complications was not different between groups insert ignore into journalissuearticles values(16% vs. 15%; p = 0.41);. Overall complications were similar between study groups insert ignore into journalissuearticles values(3 complications in each group; p = 0.73);. Secondary outcome measure: The group LTC patients were discharged earlier compared to the group LI insert ignore into journalissuearticles values(7.1 ± 2.0 days vs. 9.4 ± 2.5 days; p = 0.03);. The readmission rate after hospital discharge was higher in the LI group than the group LTC insert ignore into journalissuearticles values(18% vs. 12.5%; p = 0.02);. Conclusions: It was concluded that LTC was superior compared to LI concerning complications after low anterior resection for rectum cancer.
Keywords : Rectum cancer, low anterior resection, loop transverse colostomy, loop ileostomy