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Techniques in Coloproctology

, Volume 19, Issue 8, pp 469–474 | Cite as

When is the best time for temporary stoma closure in laparoscopic sphincter-saving surgery for rectal cancer? A study of 259 consecutive patients

  • M. N. Figueiredo
  • D. Mège
  • L. Maggiori
  • M. Ferron
  • Y. PanisEmail author
Original Article

Abstract

Background

There is no consensus regarding the best timing for temporary stoma closure after proctectomy for rectal cancer, especially if the patient requires adjuvant chemotherapy. This study aimed to assess whether the timing of stoma closure could influence postoperative morbidity.

Methods

Patients with rectal cancer undergoing laparoscopic proctectomy with temporary stoma were included and divided into three groups according to the delay of stoma closure after proctectomy: ≤60 days (Group A), 61–90 days (Group B), and >90 days (Group C).

Results

From 2008 to 2013, 259 patients (146 men, median age 61 years) were divided into Groups A (n = 65), B (n = 115), and C (n = 79). At the time of stoma closure, seven (11 %) patients received adjuvant chemotherapy in Group A versus 42 (37 %) in Group B (p = 0.0002) and 24 (30 %) in Group C (p = 0.004), and peristomal hernia was noted in four patients (6 %) in Group A versus 14 (12 %) in Group B and 21 (27 %) in Group C (p < 0.0001). Although overall postoperative morbidity was similar between groups, anastomotic leakage (at the stoma closure site) was noted in one patient in Group A versus zero in Group B versus four in Group C (p = 0.03). Median hospital stay was 5 days in Group A versus 6 in Group B versus 6 in Group C (p = 0.004).

Conclusions

Our results suggested that timing of temporary stoma closure can influence postoperative morbidity. Best results were obtained if stoma closure was performed before 90 days, even during adjuvant chemotherapy. There is no benefit in delaying stoma closure after completion of adjuvant chemotherapy.

Keywords

Temporary stoma Stoma closure Anastomotic leak Rectal cancer 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

The authors declare that informed consent was obtained from all individual participants for whom identifying information is included in this article.

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Copyright information

© Springer-Verlag Italia Srl 2015

Authors and Affiliations

  • M. N. Figueiredo
    • 1
    • 2
  • D. Mège
    • 1
  • L. Maggiori
    • 1
  • M. Ferron
    • 1
  • Y. Panis
    • 1
    Email author
  1. 1.Department of Colorectal Surgery, Beaujon Hospital, Public Assistance Hospitals of ParisUniversity of Paris VIIClichyFrance
  2. 2.Department of GastroenterologyUniversity of São Paulo Medical SchoolPinheirosBrazil

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