Prophylactic defunctioning stomas improve clinical outcomes of anastomotic leak following rectal cancer resections: An analysis of the US Rectal Cancer Consortium

Purpose Anastomotic leak (AL) is a complication of low anterior resection (LAR) that results in substantial morbidity. There is immense interest in evaluating immediate postoperative and long-term oncologic outcomes in patients who undergo diverting loop ileostomies (DLI). The purpose of this study...

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Published in:	International journal of colorectal disease 2024-03, Vol.39 (1), p.39-39
Main Authors:	Hrebinko, Katherine, Anto, Vincent P., Reitz, Katherine M., Gamboa, Adriana C., Regenbogen, Scott E., Hawkins, Alexander T., Hopkins, M. Benjamin, Ejaz, Aslam, Bauer, Philip S., Wise, Paul E., Balch, Glen C., Holder-Murray, Jennifer
Format:	Article
Language:	eng
Subjects:	Anastomosis, Surgical - adverse effects Anastomotic Leak - epidemiology Anastomotic Leak - etiology Anastomotic Leak - prevention & control Cohort Studies Female Gastroenterology Hepatology Humans Internal Medicine Male Medicine Medicine & Public Health Proctectomy - adverse effects Proctology Rectal Neoplasms - pathology Retrospective Studies Risk Factors Surgery Surgical Stomas - pathology Weight Loss
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Summary:	Purpose Anastomotic leak (AL) is a complication of low anterior resection (LAR) that results in substantial morbidity. There is immense interest in evaluating immediate postoperative and long-term oncologic outcomes in patients who undergo diverting loop ileostomies (DLI). The purpose of this study is to understand the relationship between fecal diversion, AL, and oncologic outcomes. Methods This is a retrospective multicenter cohort study using patient data obtained from the US Rectal Cancer Consortium database compiled from six academic institutions. The study population included patients with rectal adenocarcinoma undergoing LAR. The primary outcome was the incidence of AL among patients who did or did not receive DLI during LAR. Secondary outcomes included risk factors for AL, receipt of adjuvant therapy, 3-year overall survival, and 3-year recurrence. Results Of 815 patients, 38 (4.7%) suffered AL after LAR. Patients with AL were more likely to be male, have unintentional preoperative weight loss, and are less likely to undergo DLI. On multivariable analysis, DLI remained protective against AL ( p
ISSN:	0179-1958 1432-1262