Comparison of safety of loop ileostomy and loop transverse colostomy for low-lying rectal cancer patients undergoing anterior resection: A retrospective, single institution, propensity score-matched study

Author(s):  
Xiyu Sun ◽  
Huiqiao Han ◽  
Huizhong Qiu ◽  
Bin Wu ◽  
Guole Lin ◽  
...  
2019 ◽  
Vol 6 (12) ◽  
pp. 4216
Author(s):  
Saied Hosny Bendary ◽  
Abd Elfatah T. El sheikh ◽  
Mahmoud Kamal Ramadan

Background: Most colorectal cancer occurs due to lifestyle and increase age with only a minority of cases associated with underlying genetic disorders and environmental factors enables us to move in the direction of a complete assessment of disease risk. The objective of the present study was to compare between two different types of diverting stoma (loop ileostomy and transverse colostomy) as regard immediate and remote complications in patient with rectal cancer treated by restorative resection.Methods: A prospective randomized comparative clinical study was conducted on 50 patients who underwent anterior resection and low anterior resection for rectal cancer divided into two groups: Group I consisted of 25 patients who underwent by loop ileostomy. Group II consisted of 25 patients who underwent by loop transverse colostomy. All patients attended to surgical oncology unit of Sayed Galal hospital, Al Azhar University, Cairo, Egypt during the period from October 2018 to October 2019. Full history, routine, physical examination, routine and imaging investigations were done.Results: 80% and 84% of loop ileostomy and transverse colostomy patients had anterior resection, respectively with no statistically significant differences between the two studied groups regarding anterior resection. Patient who treated by loop ileostomy had deceased time of closure (5.2±0.25 weeks) and stay in hospital (5.16±1.65 and 3.29±0.55 days) than those treated by transverse colostomy (9.6±0.37 weeks) and (7.44±2.58 and 6.03±1.97 days) respectively.Conclusions: Egyptians have unique tumor characters and behavior, and different compliance with treatment regimens. Multicenter prospective studies, as well as evolving Egyptian treatment guidelines are needed to address this.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Amal Rhemouga ◽  
Stefan Buettner ◽  
Wolf O. Bechstein ◽  
Guido Woeste ◽  
Teresa Schreckenbach

Abstract Background Low anterior resection (LAR) is often performed with diverting loop ileostomy (DLI) for anastomotic protection in patients with rectal cancer. We aim to analyze, if older patients are more prone to a decline in kidney function following creation and closure of DLI after LAR for rectal carcinoma versus younger patients. Methods A retrospective cohort study from a database including 151 patients undergoing LAR for rectal carcinoma with DLI was used. Patients were divided in two age groups (Group A: <65 years, n = 79; Group B: ≥65 years, n = 72). For 123 patients undergoing DLI reversal prognostic factors for an impairment of serum creatinine (SCr) and estimated glomerular filtration rate (eGFR) 3 months after DLI reversal was analyzed using a multivariate linear regression analysis. Results SCr before LAR(T0) was significant higher in Group B (P = 0.04). Accordingly, the eGFR at T0 in group B was significantly lower (P < 0.001). No patients need to undergo hemodialysis after LAR or DLI reversal. Age and SCr at T0were able to statistically significant predict an increase in SCr (P<0.001) and eGFR (P=0.001) three months after DLI reversal (The R² for the overall model was .82 (adjusted R² = .68). Conclusion DLI creation may result in a reduction of eGFR in older patients 3 months after DLI closure. Apart from this, patients do not have a higher morbidity after creation and closure of DLI resulting from LAR regardless of their age.


Author(s):  
Hemn Hussain Kaka Ali ◽  
Qalandar Hussein Abdulkarim ◽  
Karzan Seerwan ◽  
Barham M. M .Salih

This is a multi-center retrospective study of patients underwent low anterior resection for rectal cancer. Ileostomy had been done to protect low lying Colo-rectal anastomosis, closure of ileostomy had been delayed in some patients due to patient own will, surgical complications (anastomotic leak) or coarse of chemotherapy. This study aimed to find the effect of temporary ileostomy on post-operative bowel defunction which is called Low anterior resection syndrome (LARS), and include; urgency, difficulty in emptying of bowel, and incontinence for feces and flatus.  A total of 50 patients included in this study, the age ranges from the 19 to 80 years old with a mean age of 51.96 years. The total number of males was (33, %66). Majority of patients were overweight (21, 42%). The distance of tumors from the anal verge were less than 10 cm in (31,62%). The mean duration of fecal diversion was 7.17 months. Loop ileostomy were closed before six months in (27,54%). The mean duration of diversion of patients developed no LARS was 6.87 months which is shorter than those of developed LARS (7.31). Lower BMI patients are more prone to develop LARS, while Obese patients are more susceptible to develop major LARS. Nineteen cases developed LARS among those patient’s ileostomy closed before six months, and 15 cases developed LARS in those ileostomies closed after six months.    


Author(s):  
Jung Kyong Shin ◽  
Yoon Ah Park ◽  
Jung Wook Huh ◽  
Seong Hyeon Yun ◽  
Hee Cheol Kim ◽  
...  

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