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A Journal on Surgery
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,877
Minerva Chirurgica 2011 February;66(1):49-54
An evaluation of whether neoadjuvant therapy delays closure of defunctioning loop ileostomy following anterior resection for rectal cancer
Bhangu A., Tiramula R. ✉
Department of Colorectal Surgery, Good Hope Hospital, Birmingham, UK
AIM: The aim of this study was to determine whether neoadjuvant therapy delays the closure of loop ileostomy after anterior resection.
METHODS: Review of 45 patients with loop ileostomies formed at elective surgery from 2006- 2008. T-tests and Kaplan Meier survival analysis were used.
RESULTS: At a mean follow-up of 470 days 71% (N.=32) of patients have had their ileostomy closed. Of these, 27% (N.=12, group A) proceeded straight to surgery and 63% (N.=20, group B) received neoadjuvant therapy (long course chemoradiotherapy N.=13, short course radiotherapy N.=7). There was no significant difference in time to closure between groups (group A 181 days [range 98-296]; group B was 202 days [range 98-310], P=0.416). Those with Dukes C/D disease had a longer time to closure than those with A/B (P=0.002), likely due to higher complication rates in those with Dukes C/D disease (9/20 versus 4/25, P=0.049, respectively). Cox’s regression analysis showed that only Dukes C/D stage was predictive of a longer time to closure (hazard ratio 3.289, 1.509-7.170, P=0.001).
CONCLUSION: Time to closure of loop ileostomy was not delayed by neoadjuvant therapies. Patients with Dukes C/D disease should be warned about risk of longer time to closure.