Early Versus Delayed Reversal of Covering Stoma after Low Anterior Resection for Colorectal Carcinoma

Document Type : Original Article

Authors

Surgical Oncology Unit, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Abstract

Background: A defunctioning stoma is used primarily to protect the anastomosis and prevent pelvic sepsis after bowel surgery.
Aim of the work: This study was aimed to compare early stoma closure with conventional stoma closure following defunctioning diversion stoma surgery with respect to the frequency of complications, health‐related quality of life (QOL), and length of hospitalization (LOH).
Patients and Methods: This study was designed as a prospective parallel‐arm randomized controlled trial. 40 patients who underwent temporary stoma following colorectal cancer surgery were enrolled in this study. The rate of complications (medical and surgical) following early (20 patients) and conventional (20 patients) stoma closure was assessed. Health‐related QOL and LOH were also measured.
Results: Forty patients were included, with 20 cases in each group. Postoperative complications including wound dehiscence (15% vs. 15%; P = 1.00), wound infection (40% vs. 5%; P = 0.023), intra‐abdominal collection (15% vs. 30%; P = 0.449), anastomotic leak (15%vs. 30%; P = 0.449) were comparable. The length of hospital stays and overall mortality and morbidity were similar across the two groups. There was a significant reduction in the cost towards stoma care in the early stoma closure group. Furthermore, Patients in the early stoma closure group also had a significantly better QOL. Conclusion: Early stoma closure does not carry an increased risk of postoperative complications, reduces cost towards stoma care, and leads to better a QOL.
 

Keywords

The Egyptian Journal of Hospital Medicine
Volume 73, Issue 6
October 2018
Pages 6915-6920

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