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Low or Ultralow Anterior Resection of Rectal Cancer Without Diverting Stoma: Experience with 28 Patients

Indian Journal of Surgery volume 77, pages 423–426 (2015)Cite this article

Abstract

A diverting temporary stoma is frequently used to decrease the chance of anastomosis leakage in the middle and lower rectum cancer surgeries, but its role in preventing the leakage is still doubtful. This study has been designed to evaluate any possible anastomosis complications after a rectum resection and a low or ultralow anastomosis when no diverting stoma is applied in patients with rectal cancer. Twenty-eight patients suffering from rectal cancer were treated by a low anterior resection between the years 2005 and 2008 in Imam Reza University Hospital, Mashhad, Iran. Out of the 28 patients, 6 patients had already undergone a course of neoadjuvant radiotherapy. Anastomosis was performed manually in 23 patients, using a stapler in 5 of them. None of the patients had a diverting stoma. Then, the outcome was evaluated. Fecal incontinence occurred in one of the patients (6.7 %) who had already undergone a course of radiotherapy preoperatively and had a stapler used for anastomosis. No leakage was detected in any of them. The very low incidence of complications in this study, such as those not preventable by a diverting stoma, suggest a very low chance of leakage in low or ultralow anastomosis in patients with rectal cancer and in those who were treated with neoadjuvant radiotherapy.

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Acknowledgments

The present study was supported by the Vice Chancellor for Research of Mashhad University of Medical Sciences. The authors gratefully acknowledge Ms. M. Hassanpour for revising and editing the manuscript.

Funding sources

Mashhad University of Medical Sciences

Conflict of Interest

All authors have no conflicts of interest.

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Affiliations

  1. Trauma and Acute Care Research Center, Taleghani Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

    E. Soltani

  2. Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

    A. Jangjoo & E. Saremi

Authors
  1. E. Soltani
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  2. A. Jangjoo
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  3. E. Saremi
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Correspondence to A. Jangjoo.

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Soltani, E., Jangjoo, A. & Saremi, E. Low or Ultralow Anterior Resection of Rectal Cancer Without Diverting Stoma: Experience with 28 Patients. Indian J Surg 77, 423–426 (2015). https://doi.org/10.1007/s12262-013-0863-y

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  • DOI: https://doi.org/10.1007/s12262-013-0863-y

Keywords

  • Rectal cancer
  • Diverting stoma
  • Anastomosis leakage
  • Low anterior resection