Clinical Outcomes of Ileostomy Closure during versus after Adjuvant Chemotherapy in Patients with Rectal Cancer

作者全名："He, Fan; Yang, Fuyu; Tang, Chenglin; Chen, Defei; Zhao, Dongqin; Xiong, Junjie; Zou, Yu; Huang, Guoquan; Qian, Kun"

作者地址："[He, Fan; Yang, Fuyu; Tang, Chenglin; Chen, Defei; Zhao, Dongqin; Xiong, Junjie; Zou, Yu; Qian, Kun] Chongqing Med Univ, Affiliated Hosp 1, Dept Gastrointestinal Surg, Chongqing 400016, Peoples R China; [Huang, Guoquan] Hubei Prov Key Lab Selenium Resources & Bioapplica, 158 Wuyang Ave, Enshi 445000, Hubei, Peoples R China"

通信作者："Qian, K (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Gastrointestinal Surg, Chongqing 400016, Peoples R China."

来源：CANADIAN JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001194131500001

JCR分区：Q2

影响因子：2.6

年份：2024

卷号：2024

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：　

摘要："Background. Protective ileostomy can effectively prevent severe anastomotic leakage after rectal cancer surgery; however, the optimal timing for ileostomy closure during adjuvant chemotherapy remains unclear. This study aimed to explore the safety and long-term outcomes of early ileostomy closure during adjuvant chemotherapy. Method. Patients who underwent laparoscopic rectal cancer surgery combined with protective ileostomy and adjuvant chemotherapy between April 2017 and April 2021 were retrospectively evaluated. Patients were divided into an early closure group during chemotherapy (group A) and a late closure group after chemotherapy (group B). Results. A total of 215 patients were included in this study, with 115 in group A and 100 in group B. There were no significant differences in demographic and clinical characteristics between the two groups. In group A, durations of stoma status ( p < 0.001 ) and low anterior resection syndrome (LARS) ( p < 0.001 ) were shorter, and rectal stenosis ( p = 0.036 ) and stoma-related complications ( p = 0.007 ), especially stoma stenosis ( p = 0.041 ), were less common. However, compliance with chemotherapy was worse ( p = 0.009 ). There were no significant differences in operative time, postoperative hospital stay, postoperative complications, incidence and severity of LARS, disease-free survival, or overall survival between groups. Conclusion. Early ileostomy closure can effectively reduce the duration of stoma status, duration of LARS, rectal stenosis, and stoma-related complications while not affecting surgical complications and oncological outcomes. Ileostomy closure should not be delayed because of adjuvant chemotherapy. However, follow-up should be strengthened to increase compliance and integrity with chemotherapy."

基金机构：Health Appropriate Technology Promotion Project of 2023 Chongqing; [2023jstg023]

基金资助正文：The authors are grateful to all their colleagues who helped prepare this article and Editage (https://www.editage.com) for English language editing. This research was supported by the Health Appropriate Technology Promotion Project of 2023 Chongqing (number 2023jstg023).