TY - JOUR
T1 - Long-Term Functional Outcome After Early vs. Late Stoma Closure in Rectal Cancer Surgery
T2 - Sub-analysis of the Multicenter FORCE Trial
AU - Meyer, V. M.
AU - Bosch, N.
AU - van der Heijden, J. A.G.
AU - Kalkdijk-Dijkstra, A. J.
AU - Pierie, J. P.E.N.
AU - Beets, G. L.
AU - Broens, P. M.A.
AU - Klarenbeek, B. R.
AU - van Westreenen, H. L.
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/6/26
Y1 - 2024/6/26
N2 - Purpose: The aim of this study was to assess the effect of early stoma closure on bowel function after low anterior resection (LAR) for rectal cancer. Methods: Patients participating in the FORCE trial who underwent LAR with protective stoma were included in this study. Patients were subdivided into an early closure group (< 3 months) and late closure group (> 3 months). Endpoints of this study were the Wexner Incontinence, low anterior resection syndrome (LARS), EORTC QLQ-CR29, and fecal incontinence quality of life (FIQL) scores at 1 year. Results: Between 2017 and 2020, 38 patients had received a diverting stoma after LAR for rectal cancer and could be included. There was no significant difference in LARS (31 vs. 30, p = 0.63) and Wexner score (6.2 vs. 5.8, p = 0.77) between the early and late closure groups. Time to stoma closure in days was not a predictor for LARS (R2 = 0.001, F (1,36) = 0.049, p = 0.83) or Wexner score (R2 = 0.008, F (1,36) = 0.287, p = 0.60) after restored continuity. There was no significant difference between any of the FIQL domains of lifestyle, coping, depression, and embarrassment. In the EORTC QLQ-29, body image scored higher in the late closure group (21.3 vs. 1.6, p = 0.004). Conclusion: Timing of stoma closure does not appear to affect long-term bowel function and quality of life, except for body image. To improve functional outcome, attention should be focused on other contributing factors.
AB - Purpose: The aim of this study was to assess the effect of early stoma closure on bowel function after low anterior resection (LAR) for rectal cancer. Methods: Patients participating in the FORCE trial who underwent LAR with protective stoma were included in this study. Patients were subdivided into an early closure group (< 3 months) and late closure group (> 3 months). Endpoints of this study were the Wexner Incontinence, low anterior resection syndrome (LARS), EORTC QLQ-CR29, and fecal incontinence quality of life (FIQL) scores at 1 year. Results: Between 2017 and 2020, 38 patients had received a diverting stoma after LAR for rectal cancer and could be included. There was no significant difference in LARS (31 vs. 30, p = 0.63) and Wexner score (6.2 vs. 5.8, p = 0.77) between the early and late closure groups. Time to stoma closure in days was not a predictor for LARS (R2 = 0.001, F (1,36) = 0.049, p = 0.83) or Wexner score (R2 = 0.008, F (1,36) = 0.287, p = 0.60) after restored continuity. There was no significant difference between any of the FIQL domains of lifestyle, coping, depression, and embarrassment. In the EORTC QLQ-29, body image scored higher in the late closure group (21.3 vs. 1.6, p = 0.004). Conclusion: Timing of stoma closure does not appear to affect long-term bowel function and quality of life, except for body image. To improve functional outcome, attention should be focused on other contributing factors.
KW - Anorectal function
KW - Low anterior resection
KW - Quality of life
KW - Rectal cancer
KW - Stoma closure
UR - http://www.scopus.com/inward/record.url?scp=85197145924&partnerID=8YFLogxK
U2 - 10.1007/s12029-024-01062-2
DO - 10.1007/s12029-024-01062-2
M3 - Article
C2 - 38922517
AN - SCOPUS:85197145924
SN - 1941-6628
VL - 55
SP - 1266
EP - 1273
JO - Journal of Gastrointestinal Cancer
JF - Journal of Gastrointestinal Cancer
IS - 3
ER -