Multivariate Analysis of Risk Factors Associated With the Nonreversal Ileostomy Following Sphincter-Preserving Surgery for Rectal Cancer
- Authors
- Kim, Young Ah; Lee, Gil Jae; Park, Sung Won; Lee, Won-Suk; Baek, Jeong-Heum
- Issue Date
- Jun-2015
- Publisher
- KOREAN SOC COLOPROCTOLOGY
- Keywords
- Sphincter-preserving surgery; Ileostomy; Rectal cancer
- Citation
- ANNALS OF COLOPROCTOLOGY, v.31, no.3, pp.98 - 102
- Journal Title
- ANNALS OF COLOPROCTOLOGY
- Volume
- 31
- Number
- 3
- Start Page
- 98
- End Page
- 102
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/10473
- DOI
- 10.3393/ac.2015.31.3.98
- ISSN
- 2287-9714
- Abstract
- Purpose: A loop ileostomy is used to protect an anastomosis after anal sphincter-preserving surgery, especially in patients with low rectal cancer, but little information is available concerning risk factors associated with a nonreversal ileostomy. The purpose of this study was to identify risk factors of ileostomy nonreversibility after a sphincter-saving resection for rectal cancer. Methods: Six hundred seventy-nine (679) patients with rectal cancer who underwent sphincter-preserving surgery between January 2004 and December 2011 were evaluated retrospectively. Of the 679, 135 (19.9%) underwent a defunctioning loop ileostomy of temporary intent, and these patients were divided into two groups, that is, a reversal group (RG, 112 patients) and a nonreversal group (NRG, 23 patients) according to the reversibility of the ileostomy. Results: In 23 of the 135 rectal cancer patients (17.0%) that underwent a diverting ileostomy, stoma reversal was not possible for the following reasons; stage IV rectal cancer (11, 47.8%), poor tone of the anal sphincter (4, 17.4%), local recurrence (2, 8.7%), anastomotic leakage (1, 4.3%), radiation proctitis (1, 4.3%), and patient refusal (4, 17.4%). The independent risk factors of the nonreversal group were anastomotic leakage or fistula, stage IV cancer, local recurrence, and comorbidity. Conclusion: Postoperative complications such as anastomotic leakage or fistula, advanced primary disease (stage IV), local recurrence and comorbidity were identified as risk factors of a nonreversal ileostomy. These factors should be considered when drafting prudential guidelines for ileostomy closure.
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Collections - 의과대학 > 의학과 > 1. Journal Articles
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