Preoperative risk factors and cumulative incidence of temporary ileostomy non-closure after sphincter-preserving surgery for rectal cancer: a meta-analysis

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

作者地址："[He, Fan; Tang, Chenglin; Yang, Fuyu; Chen, Defei; Xiong, Junjie; Zou, Yu; Zhao, Dongqin; Qian, Kun] Chongqing Med Univ, Dept Gastrointestinal Surg, Affiliated Hosp 1, Chongqing 400016, Peoples R China"

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

来源：WORLD JOURNAL OF SURGICAL ONCOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001201790000001

JCR分区：Q1

影响因子：2.5

年份：2024

卷号：22

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Temporary ileostomy; Risk factors; Rectal cancer; Meta-analysis

摘要："Background Temporary ileostomy (TI) has proven effective in reducing the severity of anastomotic leakage after rectal cancer surgery; however, some ileostomies fail to reverse over time, leading to conversion into a permanent stoma (PS). In this study, we aimed to investigate the preoperative risk factors and cumulative incidence of TI non-closure after sphincter-preserving surgery for rectal cancer. Materials and methods We conducted a meta-analysis after searching the Embase, Web of Science, PubMed, and MEDLINE databases from their inception until November 2023. We collected all published studies on the risk factors related to TI non-closure after sphincter-preserving surgery for rectal cancer. Results A total of 1610 studies were retrieved, and 13 studies were included for meta-analysis, comprising 3026 patients. The results of the meta-analysis showed that the identified risk factors included older age (p = 0.03), especially > 65 years of age (p = 0.03), male sex (p = 0.009), American Society of Anesthesiologists score >= 3 (p = 0.004), comorbidity (p = 0.001), and distant metastasis (p < 0.001). Body mass index, preoperative hemoglobin, preoperative albumin, preoperative carcinoma embryonic antigen, tumor location, neoadjuvant chemoradiotherapy, smoking, history of abdominal surgery, and open surgery did not significantly change the risk of TI non-closure. Conclusion We identified five preoperative risk factors for TI non-closure after sphincter-preserving surgery for rectal cancer. This information enables surgeons to identify high-risk groups before surgery, inform patients about the possibility of PS in advance, and consider performing protective colostomy or Hartmann surgery."

基金机构："Chongqing Medical University Future Medical Youth innovation team development support program [03030299QC-W0007, cstc2021jcyj-msxmX0286]"

基金资助正文：This study was supported by the Chongqing Medical University Future Medical Youth innovation team development support program (Grant number 03030299QC-W0007) and the study on the role of a new PPAR gamma transcription cofactor STK38L in adipogenic differentiation of human adipocytes (Grant number cstc2021jcyj-msxmX0286).