Effectiveness Between Early and Late Closure of Rectal Cancer Patients with Temporary Ileostomy: A Prospective Study

Publication date: Available online 2 March 2017
Source:Current Problems in Cancer
Author(s): Li Zhen, Yanan Wang, Ze Zhang, Tongwei Wu, Ruoyan Liu, Tingting Li, Liying Zhao, Haijun Deng, Xiaolong Qi, Guoxin Li
Background & aimsA temporary stoma is often used in rectal cancer surgery to protect a distal anastomosis, which remains a major concern after rectal cancer surgery, particularly after low anterior resection. The temporary stoma is scheduled for closure. However, the optimal time of closure of the protecting stoma remains unclear due to sparse studies and data. We aimed to detect the efficacy of between early and late temporary ileostomy closure in patients with rectal cancer during or after neoadjuvant chemotherapy (NACRT).MethodWe conducted a prospective, two-group design between early and late ileostomy closure group in patients after rectal cancer surgery with temporary stoma. Participants were recruited in a teaching hospital in Guangzhou, China. 161 patients confirmed diagnosis of rectal cancer underwent curative surgery and temporary ileostomy. Paticipants with temporary ileostomy received closure surgery after one (early) or six (late) months were assessed by clinical parameters and quality of life (QOL).ResultsPatients in late closure (LC) group received more adjuvant chemotherapy cycles but with comparable incidence of stoma closure-related complications and length of hospital stay compared to early closure (EC) group.ConclusionParticipants in LC group with standardized postoperative chemotherapy might have a better prognosis compared with those in EC group. An increased emphasis should be given to choose the optimal closure time of rectal cancer patients with temporary ileostomy. Colorectal nurses could provide support to physician for observation of prognosis of different closure time.



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