scholarly journals Risk Factors of Delayed Recovery of Gastrointestinal Function After Ileostomy Reversal for Rectal Cancer Patients

2021 ◽  
Vol Volume 13 ◽  
pp. 5127-5133
Author(s):  
Lili Chu ◽  
Hui Wang ◽  
Suyu Qiu ◽  
Biyan Shao ◽  
Jia Huang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rectal Cancer ◽  
Cancer Patients ◽  
Gastrointestinal Function ◽  
Ileostomy Reversal ◽  
Delayed Recovery

scholarly journals A nomogram to predict risk factors of frequent defecation early after ileostomy reversal for rectal cancer patients

2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Jiaxin Deng ◽  
Mingli Su ◽  
Jiancong Hu ◽  
Dezheng Lin ◽  
Juan Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rectal Cancer ◽  
Cancer Patients ◽  
Ileostomy Reversal

scholarly journals Less is more—the best test for anastomotic leaks in rectal cancer patients prior to ileostomy reversal

2021 ◽  
Author(s):  
Simon Lindner ◽  
Steffen Eitelbuss ◽  
Svetlana Hetjens ◽  
Joshua Gawlitza ◽  
Julia Hardt ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Cancer Patients ◽  
Methodological Quality ◽  
Colorectal Anastomosis ◽  
Digital Rectal Examination ◽  
Contrast Enema ◽  
Paired Data ◽  
Endoscopic Procedures ◽  
Rectal Examination ◽  
Ileostomy Reversal

Abstract Purpose No clear consensus exists on how to routinely assess the integrity of the colorectal anastomosis prior to ileostomy reversal. The objective of this study was to evaluate the accuracy of contrast enema, endoscopic procedures, and digital rectal examination in rectal cancer patients in this setting. Methods A systematic literature search was performed. Studies assessing at least one index test for which a 2 × 2 table was calculable were included. Hierarchical summary receiver operating characteristic curves were calculated and used for test comparison. Paired data were used where parameters could not be calculated. Methodological quality was assessed with the QUADAS-2 tool. Results Two prospective and 11 retrospective studies comprising 1903 patients were eligible for inclusion. Paired data analysis showed equal or better results for sensitivity and specificity of both endoscopic procedures and digital rectal examination compared to contrast enema. Subgroup analysis of contrast enema according to methodological quality revealed that studies with higher methodological quality reported poorer sensitivity for equal specificity and vice versa. No case was described where a contrast enema revealed an anastomotic leak that was overseen in digital rectal examination or endoscopic procedures. Conclusions Endoscopy and digital rectal examination appear to be the best diagnostic tests to assess the integrity of the colorectal anastomosis prior to ileostomy reversal. Accuracy measures of contrast enema are overestimated by studies with lower methodological quality. Synopsis of existing evidence and risk–benefit considerations justifies omission of contrast enema in favor of endoscopic and clinical assessment. Trial registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019107771

Risk factors for suboptimal laparoscopic surgery in rectal cancer patients

2020 ◽  
Author(s):  
Pere Planellas ◽  
Helena Salvador ◽  
Lídia Cornejo ◽  
Maria Buxó ◽  
Ramon Farrés ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rectal Cancer ◽  
Laparoscopic Surgery ◽  
Cancer Patients

scholarly journals Pathological Response Has Survival Benefits for Rectal Cancer following Neoadjuvant Therapy

2019 ◽  
Author(s):  
Wei-Chih Chen ◽  
Li-Jen Kuo ◽  
Chia-Che Chen ◽  
Po-Li Wei ◽  
Yu-Min Huang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rectal Cancer ◽  
Overall Survival ◽  
Neoadjuvant Therapy ◽  
Cancer Patients ◽  
Associated Factors ◽  
Disease Recurrence ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
N Stage

Abstract Background Studies reporting the results of associated factors of pathological completed response (PCR) and tumor regression response in patients with rectal cancer following neoadjuvant chemoradiation therapy (nCRT) are inconsistent. The purpose of this study was to identify the prognostic factors of tumor response and outcome in rectal cancer patients.Methods The study was a retrospective analysis. Patients with locally advanced rectal cancer underwent nCRT followed by surgery from 2010 to 2014 with 5 years of follow-up. The primary outcomes were associated factors of pathological completed response and downstaging. The risk factors of survival outcome and disease recurrence were also observed.Results A total of 169 rectal cancer patients were included. The PCR rate was 17.8%, and the downstaging rate was 60.9%. Patients with a histology type of adenocarcinoma associated with PCR, and patients positive for clinical N stage were associated with downstaging. Kaplan-Meier analysis showed the PCR group performed better to a statistically significant level both in overall survival and disease recurrence free survival than the no PCR group (p= 0.033 & 0.025, respectively). Patients with a downstaging response also showed better overall survival benefits and disease recurrence free survival benefits than their counter-parts (both p<0.001). After controlling confounding variables, the risk factors of overall survival were downstaging [Hazard Ratio (HR): 0.40, 95% CI: 0.21-0.74], male, abnormal post-nCRT CEA level and abnormal Hb level. In addition, the protective factors of recurrence were downstaging and having adjuvant chemotherapy.Conclusions Among rectal cancer patients who received the neoadjuvant therapy, histology type and clinical N stage were associated with PCR and downstaging, respectively. Downstaging was an important protective factor for better overall survival and recurrence free survival.

scholarly journals The incidence of incisional hernias following ileostomy reversal in colorectal cancer patients treated with anterior resection

2017 ◽  
Vol 99 (4) ◽  
pp. 319-324 ◽  
Author(s):  
Balazs Fazekas ◽  
Bence Fazekas ◽  
J Hendricks ◽  
N Smart ◽  
T Arulampalam
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Incisional Hernia ◽  
Cancer Patients ◽  
Anterior Resection ◽  
Incisional Hernias ◽  
Hernia Formation ◽  
Reversal Time ◽  
Ileostomy Reversal ◽  
Colorectal Cancer Patients

INTRODUCTION The aim of this study was to identify the rate of incisional hernia formation following ileostomy reversal in patients who underwent anterior resection for colorectal cancer. In addition, we aimed to ascertain risk factors for the development of reversal-site incisional hernias and to record the characteristics of the resultant hernias. MATERIALS AND METHODS Using a prospectively compiled database of colorectal cancer patients who were treated with anterior resection, we identified individuals who had undergone both ileostomy formation and subsequent reversal of their ileostomies from January 2005 to December 2014. Medical records were reviewed to record descriptive patient data about risk factors for hernia formation, operative details and any subsequent operations. Computed tomography reports were reviewed to identify the number, site and characteristics of incisional hernias. RESULTS A total of 121 patients were included in this study; 14.9% (n = 18) developed an incisional hernia at the ileostomy reversal site; 17.4% (n = 21) at a non-ileostomy site and 6.6% (n = 8) developed both. The reversal-site hernias were smaller both in width and length compared with the non-ileostomy-site hernias. Risk factors for the development of reversal-site incisional hernias were higher body mass index (BMI), lower age, open surgery, longer reversal time and a history of previous hernias. We did not detect a difference in the size of the incisional hernias that developed in patients with these specific risk factors. CONCLUSIONS Incisional hernias are a significant complication of ileostomy reversal. Further evaluation of the use of prophylactic mesh to reduce the incidence of incisional hernias may be worthwhile.

650 POSTOPERATIVE EARLY ORAL FEEDING PROGRAM ACCELERATES THE RECOVERY OF GASTROINTESTINAL FUNCTION IN ESOPHAGEAL CANCER PATIENTS

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Peiyu Wang ◽  
Xiankai Chen ◽  
Yin Li ◽  
Xianben Liu
Keyword(s):  
Esophageal Cancer ◽  
Cancer Patients ◽  
Protective Factor ◽  
Bowel Movement ◽  
Repeated Measurements ◽  
Oral Feeding ◽  
Gastrointestinal Function ◽  
Early Oral Feeding ◽  
Feeding Program ◽  
Delayed Recovery

Abstract   Although the early oral feeding program (EOF) pasting the esophagectomy has been demonstrated to be valuable in attenuating inflammatory responses and shortening hospital stay without increasing complications, its impacts on gastrointestinal function recovery have not been elegantly investigated. This study aimed to solve these issues. Methods A total of 110 esophageal cancer patients were included after reviewing a prospective database. Patients of EOF group were compared with patients of late oral feeding (LOF) group with respects to the appearance of first flatus and bowel movement after esophagectomy. Perioperative changes in serum gastrointestinal hormones were compared between EOF group and LOF group using variance analysis of repeated measurements. Multivariable logistic regression was conducted to detect risk factors for delayed recovery of gastrointestinal function after esophagectomy. Results Patients of EOF group showed significantly shorter time from the surgery to the appearance of first flatus (2.1 ± 0.8 d vs 3.4 ± 1.2 d, P &lt; 0.001) and bowel movement (3.2 ± 0.9 d vs. 5.5 ± 1.5 d, P &lt; 0.001) than those of LOF group. Patients of EOF showed increased levels of serum gastrin (P = 0.007) and motilin (P = 0.027) but decreased levels of somatostatin (P = 0.004) and cholecystokinin (P = 0.028) than patients of LOF group based on the repeated measurements on postoperative day 1, 3, and 5. Multivariable analysis demonstrated the EOF (vs. LOF) as a protective factor for delayed recovery of gastrointestinal function. Conclusion The postoperative EOF was demonstrated to accelerate the recovery of gastrointestinal function in esophageal cancer patients from the levels of clinical manifestation and hormone secretion. The EOF was anticipated to be highlighted in promoting perioperative managements.

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