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Impact of chemotherapy on surgical outcomes in ileostomy reversal: a propensity score matching study from a single centre

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Abstract

Purpose

In patients with chemotherapy, there is no consensus on the timing of ileostomy closure. Ileostomy reversal could improve the quality of life and minimise the long-term adverse events of delayed closure. In this study, we evaluated the impact of chemotherapy on ileostomy closure and searched for the predictive factors for complications.

Methods

We retrospectively analysed 212 patients with rectal cancer who underwent ileostomy closure surgery during and without chemotherapy and were consecutively enrolled between 2010 and 2016. As a result of the heterogeneity of the two groups, propensity score matching (PSM) was performed with a 1:1 PSM cohort.

Results

A total of 162 patients were included in the analysis. The overall stoma closure-related complications (12.4% vs. 11.1%, p = 1.00) and major complications (2.5% vs. 6.2%, p = 0.44) were not significantly different between the two groups. Multivariate analysis demonstrated that chronic kidney disease and bevacizumab use are risk factors for major complications.

Conclusion

Patients with oral or intravenous chemotherapy can safely have ileostomy closure with an adequate time delay from chemotherapy. When patients use bevacizumab, major complications related to ileostomy closure should still be cautioned.

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Funding

This study received no specific grant from any funding agency.

Author information

Authors and Affiliations

  1. Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan

    H.-H. Cheng

  2. Division of Colorectal Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan

    H.-H. Cheng, Y.-C. Shao, C.-Y. Lin, T.-W. Chiang, M.-C. Chen, T.-Y. Chiu, Y.-L. Huang, C.-C. Chen, C.-P. Chen & F.-F. Chiang

  3. Department of Surgery, Faculty of Medicine, School of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan

    H.-H. Cheng, Y.-C. Shao & C.-Y. Lin

  4. Division of Colorectal Surgery, Department of Surgery, China Medical University Hsinchu Hospital, Hsinchu, Taiwan

    Y.-C. Shao

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  1. H.-H. Cheng
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Correspondence to H.-H. Cheng.

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Conflict of interest

All authors declare no conflicts of interest.

Ethical approval

This study was approved by the local institutional review board (IRB number CE18031B).

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Informed consent was not required for this retrospective cohort study.

Research involving human and animal participants

The data that support the findings of this study are not available on request from the corresponding author (HHC). The data are not publicly available due to compromising the privacy of research participants.

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Cheng, HH., Shao, YC., Lin, CY. et al. Impact of chemotherapy on surgical outcomes in ileostomy reversal: a propensity score matching study from a single centre. Tech Coloproctol 27, 1227–1234 (2023). https://doi.org/10.1007/s10151-023-02790-6

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  • DOI: https://doi.org/10.1007/s10151-023-02790-6

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