Role and Morbidity of Protective Ileostomy after Anterior Resection for Rectal Cancer: One Centre Experience and Review of Literature
The creation of a protective stoma is considered a valid life-saving tool, significantly reducing the effects of anastomotic leakage in terms of related morbidity, mortality, and reoperation rate. The aim of this study was to evaluate the impact of a protective loop ileostomy in terms of short- and...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-11-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/23/7229 |
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| author | Claudio Coco Vincenzo Tondolo Luca Emanuele Amodio Donato Paolo Pafundi Federica Marzi Gianluca Rizzo |
| author_facet | Claudio Coco Vincenzo Tondolo Luca Emanuele Amodio Donato Paolo Pafundi Federica Marzi Gianluca Rizzo |
| author_sort | Claudio Coco |
| collection | DOAJ |
| description | The creation of a protective stoma is considered a valid life-saving tool, significantly reducing the effects of anastomotic leakage in terms of related morbidity, mortality, and reoperation rate. The aim of this study was to evaluate the impact of a protective loop ileostomy in terms of short- and long-term postoperative morbidity, quantifying the stoma-related complications arising after stoma creation and stoma closure and the risk of permanent stoma. From January 2009 to January 2020, 149 patients with rectal cancer treated by anterior resection and protective ileostomy were enrolled in the study. A total of 113 (75.84%) patients were preoperatively treated with neoadjuvant radiochemotherapy. A clinically relevant anastomotic leak occurred in two patients (1.34%). The postoperative stoma complication rate was 6%. According to the Clavien classification, the stoma-related complication grade was I in seven patients (4.7%) and II in two patients (1.3%). A late stoma-related parastomal hernia occurred in one patient (0.67%). In 129 patients (86.57%), it was possible to close the stoma. Postoperative complications of stoma closure occurred in 12 patients (9.3%). The stoma closure complication grade was I in seven cases (5.43%), II in two cases (1.55%), and ≥3 in three cases (2.33%). Incisional hernia was the only late complication recorded in seven cases (5.42%). The permanent stoma rate was 13.43%. A protective ileostomy has a nonnegligible complication rate, but the rate of severe complications is low. Every effort should be made to clearly identify patients in whom the risk of anastomotic leakage justifies the stoma. |
| first_indexed | 2024-03-09T01:48:36Z |
| format | Article |
| id | doaj.art-1c104da096564a82aee108c7f25d1440 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T01:48:36Z |
| publishDate | 2023-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-1c104da096564a82aee108c7f25d14402023-12-08T15:18:43ZengMDPI AGJournal of Clinical Medicine2077-03832023-11-011223722910.3390/jcm12237229Role and Morbidity of Protective Ileostomy after Anterior Resection for Rectal Cancer: One Centre Experience and Review of LiteratureClaudio Coco0Vincenzo Tondolo1Luca Emanuele Amodio2Donato Paolo Pafundi3Federica Marzi4Gianluca Rizzo5U.O.C. Chirurgia Generale 2, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, ItalyDigestive and Colo-Rectal Surgery Unit, Ospedale Isola Tiberina-Gemelli Isola, 00186 Rome, ItalyDigestive and Colo-Rectal Surgery Unit, Ospedale Isola Tiberina-Gemelli Isola, 00186 Rome, ItalyU.O.C. Chirurgia Generale 2, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, ItalyDigestive and Colo-Rectal Surgery Unit, Ospedale Isola Tiberina-Gemelli Isola, 00186 Rome, ItalyDigestive and Colo-Rectal Surgery Unit, Ospedale Isola Tiberina-Gemelli Isola, 00186 Rome, ItalyThe creation of a protective stoma is considered a valid life-saving tool, significantly reducing the effects of anastomotic leakage in terms of related morbidity, mortality, and reoperation rate. The aim of this study was to evaluate the impact of a protective loop ileostomy in terms of short- and long-term postoperative morbidity, quantifying the stoma-related complications arising after stoma creation and stoma closure and the risk of permanent stoma. From January 2009 to January 2020, 149 patients with rectal cancer treated by anterior resection and protective ileostomy were enrolled in the study. A total of 113 (75.84%) patients were preoperatively treated with neoadjuvant radiochemotherapy. A clinically relevant anastomotic leak occurred in two patients (1.34%). The postoperative stoma complication rate was 6%. According to the Clavien classification, the stoma-related complication grade was I in seven patients (4.7%) and II in two patients (1.3%). A late stoma-related parastomal hernia occurred in one patient (0.67%). In 129 patients (86.57%), it was possible to close the stoma. Postoperative complications of stoma closure occurred in 12 patients (9.3%). The stoma closure complication grade was I in seven cases (5.43%), II in two cases (1.55%), and ≥3 in three cases (2.33%). Incisional hernia was the only late complication recorded in seven cases (5.42%). The permanent stoma rate was 13.43%. A protective ileostomy has a nonnegligible complication rate, but the rate of severe complications is low. Every effort should be made to clearly identify patients in whom the risk of anastomotic leakage justifies the stoma.https://www.mdpi.com/2077-0383/12/23/7229rectal canceranterior resectionanastomotic leakprotective stomastoma closure |
| spellingShingle | Claudio Coco Vincenzo Tondolo Luca Emanuele Amodio Donato Paolo Pafundi Federica Marzi Gianluca Rizzo Role and Morbidity of Protective Ileostomy after Anterior Resection for Rectal Cancer: One Centre Experience and Review of Literature Journal of Clinical Medicine rectal cancer anterior resection anastomotic leak protective stoma stoma closure |
| title | Role and Morbidity of Protective Ileostomy after Anterior Resection for Rectal Cancer: One Centre Experience and Review of Literature |
| title_full | Role and Morbidity of Protective Ileostomy after Anterior Resection for Rectal Cancer: One Centre Experience and Review of Literature |
| title_fullStr | Role and Morbidity of Protective Ileostomy after Anterior Resection for Rectal Cancer: One Centre Experience and Review of Literature |
| title_full_unstemmed | Role and Morbidity of Protective Ileostomy after Anterior Resection for Rectal Cancer: One Centre Experience and Review of Literature |
| title_short | Role and Morbidity of Protective Ileostomy after Anterior Resection for Rectal Cancer: One Centre Experience and Review of Literature |
| title_sort | role and morbidity of protective ileostomy after anterior resection for rectal cancer one centre experience and review of literature |
| topic | rectal cancer anterior resection anastomotic leak protective stoma stoma closure |
| url | https://www.mdpi.com/2077-0383/12/23/7229 |
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