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Article: Prospective evaluation of selective defunctioning stoma for low anterior resection with total mesorectal excision

TitleProspective evaluation of selective defunctioning stoma for low anterior resection with total mesorectal excision
Authors
Issue Date1999
PublisherSpringer New York LLC. The Journal's web site is located at http://link.springer.de/link/service/journals/00268/
Citation
World Journal Of Surgery, 1999, v. 23 n. 5, p. 463-468 How to Cite?
AbstractLow anterior resection with total mesorectal excision for rectal carcinoma is associated with a high anastomotic leakage rate, and the effectiveness of a defunctioning stoma in preventing anastomotic leakage remains controversial. In this study a polio of selective defunctioning stoma for stapled colorectal anastomosis after low anterior resection with total mesorectal excision in 148 consecutive patients was evaluated prospectively. A defunctioning stoma was performed in 61 patients (41%) considered at high risk of anastomotic leakage. Clinical leakage occurred in 2 patients (3.3%) with a stoma and 11 patients (12.6%) without a stoma (p = 0.047). Among those without a stoma, the leakage rate among male patients (20.9%) was significantly higher than that for female patients (4.5%) (p = 0.022). Leakage subsided with conservative treatment in the two patients with a stoma, but seven patients without a stoma developed peritonitis requiring laparotomy. No deaths resulted from leakage, and there was one hospital death (0.6%) in the whole group. Median hospital stay was similar with and without a stoma (13.0 vs. 12.0 days) (p = 0.290). Closure of the stoma was associated with no mortality, a morbidity rate of 8.7%, and a median hospital stay of 6.0 days. In conclusion, a defunctioning stoma is effective in preventing clinical anastomotic leakage after low anterior resection with total mesorectal excision. The relatively high incidence of leakage in the low risk group indicates the difficulty of predicting anastomotic leakage and hence the need for more liberal use of a defunctioning stoma especially in male patients.
Persistent Identifierhttp://hdl.handle.net/10722/83244
ISSN
2015 Impact Factor: 2.523
2015 SCImago Journal Rankings: 1.375
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorPoon, RTPen_HK
dc.contributor.authorChu, KWen_HK
dc.contributor.authorHo, JWCen_HK
dc.contributor.authorChan, CWen_HK
dc.contributor.authorLaw, WLen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2010-09-06T08:38:43Z-
dc.date.available2010-09-06T08:38:43Z-
dc.date.issued1999en_HK
dc.identifier.citationWorld Journal Of Surgery, 1999, v. 23 n. 5, p. 463-468en_HK
dc.identifier.issn0364-2313en_HK
dc.identifier.urihttp://hdl.handle.net/10722/83244-
dc.description.abstractLow anterior resection with total mesorectal excision for rectal carcinoma is associated with a high anastomotic leakage rate, and the effectiveness of a defunctioning stoma in preventing anastomotic leakage remains controversial. In this study a polio of selective defunctioning stoma for stapled colorectal anastomosis after low anterior resection with total mesorectal excision in 148 consecutive patients was evaluated prospectively. A defunctioning stoma was performed in 61 patients (41%) considered at high risk of anastomotic leakage. Clinical leakage occurred in 2 patients (3.3%) with a stoma and 11 patients (12.6%) without a stoma (p = 0.047). Among those without a stoma, the leakage rate among male patients (20.9%) was significantly higher than that for female patients (4.5%) (p = 0.022). Leakage subsided with conservative treatment in the two patients with a stoma, but seven patients without a stoma developed peritonitis requiring laparotomy. No deaths resulted from leakage, and there was one hospital death (0.6%) in the whole group. Median hospital stay was similar with and without a stoma (13.0 vs. 12.0 days) (p = 0.290). Closure of the stoma was associated with no mortality, a morbidity rate of 8.7%, and a median hospital stay of 6.0 days. In conclusion, a defunctioning stoma is effective in preventing clinical anastomotic leakage after low anterior resection with total mesorectal excision. The relatively high incidence of leakage in the low risk group indicates the difficulty of predicting anastomotic leakage and hence the need for more liberal use of a defunctioning stoma especially in male patients.en_HK
dc.languageengen_HK
dc.publisherSpringer New York LLC. The Journal's web site is located at http://link.springer.de/link/service/journals/00268/en_HK
dc.relation.ispartofWorld Journal of Surgeryen_HK
dc.titleProspective evaluation of selective defunctioning stoma for low anterior resection with total mesorectal excisionen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0364-2313&volume=23&spage=463&epage=468&date=1999&atitle=Prospective+evaluation+of+selective+defunctioning+stoma+for+low+anterior+resection+with+total+mesorectal+excisionen_HK
dc.identifier.emailPoon, RTP: poontp@hku.hken_HK
dc.identifier.emailLaw, WL: lawwl@hkucc.hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityPoon, RTP=rp00446en_HK
dc.identifier.authorityLaw, WL=rp00436en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.pmid10085394-
dc.identifier.scopuseid_2-s2.0-0032953018en_HK
dc.identifier.hkuros40370en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0032953018&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume23en_HK
dc.identifier.issue5en_HK
dc.identifier.spage463en_HK
dc.identifier.epage468en_HK
dc.identifier.isiWOS:000079546700007-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridPoon, RTP=7103097223en_HK
dc.identifier.scopusauthoridChu, KW=7402453653en_HK
dc.identifier.scopusauthoridHo, JWC=7402649983en_HK
dc.identifier.scopusauthoridChan, CW=7404813871en_HK
dc.identifier.scopusauthoridLaw, WL=7103147867en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

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