The Effect of a Temporary Stoma on Long-term Functional Outcomes Following Surgery for Rectal Cancer

Sanne J. Verkuijl*, Jara E. Jonker, Edgar J.B. Furnée, Wendy Kelder, Christiaan Hoff, Daniel A. Hess, Fennie Wit, Ronald J. Zijlstra, Monika Trzpis, Paul M.A. Broens

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Scopus)
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Abstract

BACKGROUND: Patients with rectal cancer may undergo surgical resection with or without a temporary stoma.

OBJECTIVE: This study primarily aimed to compare long-term functional outcomes between patients with and without a temporary stoma after surgery for rectal cancer. The secondary aim was to investigate the effect of time to stoma reversal on functional outcomes.

DESIGN: This was a multicenter, cross-sectional study.

SETTINGS: This study was conducted at 7 Dutch hospitals. 

PATIENTS: Included were patients who had undergone rectal cancer surgery (2009–2015). Excluded were deceased patients, who were deceased, had a permanent stoma, or had intellectual disability. 

MAIN OUTCOME MEASURES: Functional outcomes were measured using the Rome IV criteria for constipation and fecal incontinence and the low anterior resection syndrome score. 

RESULTS: Of 656 patients, 32% received a temporary ileostomy and 20% a temporary colostomy (86% response). Follow-up was at 56 (interquartile range, 38.5–79) months. Patients who had a temporary ileostomy experienced less constipation, more fecal incontinence, and more major low anterior resection syndrome than those without a temporary stoma. Patients who had a temporary colostomy experienced more major low anterior resection syndrome than those without a temporary stoma. A temporary ileostomy or colostomy was not associated with constipation or fecal incontinence after correction for confounding factors (eg, anastomotic height, anastomotic leakage, radiotherapy). Time to stoma reversal was not associated with constipation, fecal incontinence, or major low anterior resection syndrome. 

LIMITATIONS: Cross-sectional design. 

CONCLUSIONS: Although patients with a temporary ileostomy or colostomy have worse functional outcomes in the long term, it seems that the reason for creating a temporary stoma, rather than the stoma itself, underlies this phenomenon. Time to reversal of a temporary stoma does not influence functional outcomes.

BACKGROUND: Patients with rectal cancer may undergo surgical resection with or without a temporary stoma. OBJECTIVE: This study primarily aimed to compare long-term functional outcomes between patients with and without a temporary stoma after surgery for rectal cancer. The secondary aim was to investigate the effect of time to stoma reversal on functional outcomes. DESIGN: This was a multicenter, cross-sectional study.

Original languageEnglish
Pages (from-to)291-301
Number of pages11
JournalDiseases of the Colon and Rectum
Volume67
Issue number2
DOIs
Publication statusPublished - Feb-2024

Keywords

  • Bowel dysfunction
  • Follow-up
  • Postoperative
  • Rectal cancer
  • Stoma

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