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The impact of postoperative complications severity on stoma reversal following sphincter-preserving surgery for rectal cancer

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Abstract

Background

Currently, the relationship between temporary stoma reversal and the severity of postoperative complications (POCs) after the index surgery based on the Clavien–Dindo classification has not yet been explored.

Methods

From July 2010 to June 2016, 380 patients undergoing sphincter-preserving surgery for rectal cancer with a temporary stoma in our hospital were included. Temporary stoma nonclosure rates, disease-free survival rates, and overall survival rates were estimated utilizing the Kaplan–Meier method.

Results

Of all the 380 patients, primary stomas were created in 335 patients and secondary stomas in 45 patients. After the index surgery, 36.6% (139/380) of patients developed at least one postoperative complication. In the first analysis, which included all the patients, 24.7% of temporary stomas remained unclosed. In the second analysis for 335 patients with a primary stoma, 23.3% were left with unclosed stomas. After the COX regression analysis, both major POCs and minor POCs were found to be independent risk factors for the permanent stoma, and there was an increasing tendency toward the risk of permanent stoma with the increase in POC severity.

Conclusion

POCs are independent predictors of permanent stoma after rectal cancer surgery. Even minor POCs may affect the outcome, while there is a clear direct relationship between POC severity and permanent stoma rates.

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Data availability

The data supporting the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of General Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, China

    Kang Hu, Ke Tan, Wang Li, Anping Zhang, Fan Li, Chunxue Li, Baohua Liu, Song Zhao & Weidong Tong

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  1. Kang Hu
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  2. Ke Tan
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  3. Wang Li
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  4. Anping Zhang
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  5. Fan Li
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  6. Chunxue Li
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  7. Baohua Liu
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  8. Song Zhao
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  9. Weidong Tong
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Contributions

KH and WDT participated in the conception and design, data collection, statistical analysis, and writing of the manuscript. KT, WL and SZ participated in the analysis and interpretation of data, and revision of the manuscript. APZ, FL, and CXL, BHL contributed to the critical revision of the manuscript and interpretation of data. All the authors read and approved the final manuscript.

Corresponding author

Correspondence to Weidong Tong.

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Ethics approval

The current study was approved by the Ethics Committee of Daping Hospital, and written informed consent was waived due to the retrospective nature. All authors have seen the manuscript and approved to submit it to your journal.

Conflict of interest

The authors declare no competing interests.

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Hu, K., Tan, K., Li, W. et al. The impact of postoperative complications severity on stoma reversal following sphincter-preserving surgery for rectal cancer. Langenbecks Arch Surg 407, 2959–2967 (2022). https://doi.org/10.1007/s00423-022-02589-3

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  • DOI: https://doi.org/10.1007/s00423-022-02589-3

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