Many Stomas in Rectal Cancer Patients Not Reversed

Postoperative complications cause reluctance to close

THURSDAY, March 15 (HealthDay News) -- Almost one-fifth of stomas created in rectal cancer patients undergoing total mesorectal excision are never closed, largely as a result of postoperative complications, according to the results of a study published online March 15 in The Lancet Oncology.

Cornelis J.H. van de Velde, M.D., of Leiden University Medical Center in Leiden, the Netherlands, and colleagues analyzed data on 924 Dutch rectal cancer patients who underwent a low anterior resection.

A primary stoma was created in 523 patients (57 percent), of which 19 percent were never reversed. There was a positive association between the likelihood of a stoma not being reversed and postoperative complications and secondary constructed stomas. There was no association between perioperative complications and stoma reversal.

"Postoperative complications are an important limiting factor for stoma reversal because, after occurrence of these complications, patients and surgeons might be reluctant to reverse the stoma, so a substantial proportion of these stomas are never closed," the authors conclude. "Our results do not suggest that the unreversed stomas should not have been made, but show that temporary stomas should be created as if they are permanent stomas; correct placement that helps life-long handling is of utmost importance."

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