The indications for a diverting stoma in low anterior resection for rectal cancer: a prospective multicentre study of 222 patients from Japanese cancer centers |
| |
| Authors: | A. Shiomi M. Ito N. Saito T. Hirai M. Ohue Y. Kubo Y. Takii T. Sudo M. Kotake Y. Moriya |
| |
| Affiliation: | 1. Division of Colorectal Surgery, Shizuoka Cancer Center Hospital, Nagaizumi‐cho, Sunto‐gun, Shizuoka, Japan;2. Division of Colorectal Surgery, National Cancer Center Hospital East, Kashiwa‐shi, Chiba, Japan;3. Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Chikusa‐ku, Nagoya, Japan;4. Division of Surgical Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Higashinari‐ku, Osaka, Japan;5. Department of Surgical Oncology, National Hospital Organization Shikoku Cancer Center Hospital, Matsuyama, Ehime, Japan;6. Department of Surgical Oncology, Niigata Cancer Center Hospital, Chuo‐ku, Niigata, Japan;7. Department of Surgical Oncology, Yamagata Prefectural Central Hospital, Yamagata, Japan;8. Department of Surgical Oncology, Ishikawa Prefectural Central Hospital, Kanazawa, Ishikawa, Japan;9. Division of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan |
| |
| Abstract: | Aim The aim of the study was to determine the present state of diverting stoma construction in Japanese cancer centres and to investigate the relationship between symptomatic leakage and diverting stoma after low anterior resection for rectal cancer. Method Two hundred and twenty‐two consecutive patients undergoing low anterior resection for rectal cancer located within 10 cm from the anal verge were investigated in a prospective, multicenter study. Results The overall leakage rate was 9.0% (20/222). Of 31 cases with an anastomosis within 2.0 cm from the anal verge, 22 (71%) had a diverting stoma. Of cases anastomosed within 5.0 cm, the absence of a diverting stoma and tumour size were significantly related to an increased rate of leakage [leakage in 13 (12.7%) of 102 cases without a diverting stoma; in three (3.8%) of 80 cases with a diverting stoma]. Among anastomoses within 2.0 cm from the anal verge, leakage occurred in four (44.4%) of nine cases without and in none (0%) of 22 cases with a diverting stoma. Conclusion We recommend a diverting stoma for an anastomosis within 5.0 cm of the anal verge and strongly recommend it for a very low anastomosis within 2.0 cm. |
| |
| Keywords: | Rectal cancer low anterior resection anastomotic leakage diverting stoma defunctioning stoma |
|
|
