Abstract:
OBJECTIVE:The objective of this study is to identify rates and factors associated with permanent diversion following restorative proctosigmoidectomy for rectal cancer when complicated by an anastomotic leak. DESIGN:This study is a retrospective review. SETTING:The setting of this study is a tertiary referral hospital PATIENTS:Patients involved in this study were those who underwent restorative rectal cancer surgery from 1997 through 2008 identified from an institutional cancer database. INTERVENTIONS:No interventions were performed in this study. MAIN OUTCOME MEASURES:Factors associated with time to ostomy closure and rates of permanent diversion following anastomotic leaks RESULTS:One hundred and thirty patients (mean age 59.7 years) were identified, 111 (85%) of whom had stoma diversion at the index surgery. Asymptomatic occult radiological leaks occurred in 52 patients (40%). Seventy-eight patients (60%) underwent ultimate ostomy closure at a median time of 6.3 months after the index surgery, which was not significantly affected by previous radiotherapy (p = 0.08). Twelve patients (9%) underwent anastomotic reconstruction. Pathologic stage II or greater (OR 4.42; 1.95-10.04), symptomatic presentation (OR 4.13; 1.86-9.19) and anastomotic disruption >5 mm (OR 4.42; 2.01-9.74) were independently associated with permanent diversion. Among all survivors, 33% did not have their ostomy reversed. Stoma diversion constructed after leak detection in 19 patients (15%) did not affect permanent stoma rate (OR 0.86; 0.31-2.34) or time to stoma closure (p = 0.29). CONCLUSIONS:The majority of anastomotic leaks after restorative rectal cancer surgery can be salvaged without anastomotic reconstruction. However, in one third of the patients, an anastomotic leak results in a permanent stoma.
journal_name
Int J Colorectal Disjournal_title
International journal of colorectal diseaseauthors
Ogilvie JW Jr,Dietz DW,Stocchi Ldoi
10.1007/s00384-012-1423-9subject
Has Abstractpub_date
2012-10-01 00:00:00pages
1259-66issue
10eissn
0179-1958issn
1432-1262journal_volume
27pub_type
杂志文章abstract:AIM:An illustration of the diagnosis and management of tailgut cysts. MATERIALS AND METHODS:Two cases of tailgut cyst and a review of the literature. RESULTS:A female patient presented with acute urinary retention with a retrorectal mass felt during rectal examination and confirmed on ultrasound and magnetic resonanc...
journal_title:International journal of colorectal disease
pub_type: 杂志文章,评审
doi:10.1007/s00384-008-0598-6
更新日期:2009-03-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate the effect of intrahepatic microvascular and lymphatic infiltration on survival in cases of colorectal liver metastases. MATERIALS AND METHODS:Prospectively collected data of 331 patients were analyzed for microvascular invasion (V), lymphatic infiltration (L), and r...
journal_title:International journal of colorectal disease
pub_type: 临床试验,杂志文章
doi:10.1007/s00384-009-0674-6
更新日期:2009-07-01 00:00:00
abstract:PURPOSE:Appendectomy has been the gold standard for every form of appendicitis. In recent years, though, it has repeatedly been claimed that for acute uncomplicated appendicitis, antibiotic therapy can be an equivalent treatment. The aim of this meta-analysis was to determine if antibiotic therapy is a safe and effecti...
journal_title:International journal of colorectal disease
pub_type: 杂志文章,meta分析
doi:10.1007/s00384-019-03296-0
更新日期:2019-06-01 00:00:00
abstract::Anal fissure is a common condition affecting young to middle-aged adults. It causes severe pain on defecation and rectal bleeding. The aetiology remains uncertain. Spasm of the internal anal sphincter is a constant feature. Nitric oxide (NO) is the major inhibitory neurotransmitter of the internal anal sphincter (IAS)...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-005-0757-y
更新日期:2006-10-01 00:00:00
abstract:BACKGROUND:Current evidence suggests a survival benefit to post-operative surveillance following curative colorectal cancer resection; however, there is still no consensus on the optimal duration and form. OBJECTIVES:The objective is to prospectively audit outcomes of an intensive colorectal cancer follow-up scheme fo...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-015-2356-x
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Current guidelines support the use of adjuvant chemotherapy (CT) following neoadjuvant chemoradiotherapy (CTRT) and surgery to treat rectal cancer, although clinical trials have provided little evidence that it is effective. We performed a systematic review of published studies to assess whether adjuvant CT ...
journal_title:International journal of colorectal disease
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s00384-014-2082-9
更新日期:2015-04-01 00:00:00
abstract:PURPOSE:Colorectal cancer is a common malignancy and one of the major causes of cancer-related deaths worldwide. Similar to other human cancers, tumor metastasis is the biggest obstacle in the clinical treatment of colorectal cancer. In this study, we explored the functional role of SLIT2 in colon tumor metastasis and ...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-013-1641-9
更新日期:2013-07-01 00:00:00
abstract:UNLABELLED:Patients with rectal cancer may develop local recurrence despite cancer resection plus treatment with high dose radiation therapy. In this report, symptomatic patients received benefit from repeat resection. The morbidity and mortality can be maintained at an acceptable level with meticulous dissections and ...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s003840050049
更新日期:1996-01-01 00:00:00
abstract:PURPOSE:The diagnosis of irritable bowel syndrome is symptom based, and colonoscopy is the most direct way to rule out organic colonic diseases. It is controversial on the necessity of colonoscopy for patients with suspected irritable bowel syndrome and lacking alarm features. This study was designed to verify the orga...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-011-1163-2
更新日期:2011-07-01 00:00:00
abstract:INTRODUCTION:It is generally believed that resumption of feeding after colorectal resection is indicated only after recovery of bowel function. This study was designed to verify safety, feasibility, and tolerance of early oral postoperative feeding (EOF) outside an enhanced recovery after surgery (ERAS) program. MATER...
journal_title:International journal of colorectal disease
pub_type: 临床试验,杂志文章
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更新日期:2011-06-01 00:00:00
abstract:BACKGROUND:Colorectal high-grade intraepithelial neoplasia is defined as a high-grade neoplastic lesion with no invasion of submucosa. Because pathological evaluation has inevitable sampling errors, invasive cancer may be underdiagnosed as high-grade intraepithelial neoplasia by regarding submucosa invasion as an indis...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-014-2001-0
更新日期:2014-12-01 00:00:00
abstract:PURPOSE:The duodenum as primary site for gastrointestinal stromal tumors (GISTs) is rare and mitotic rate, tumor size, type of mutation and number of chromosomal aberrations have prognostic implications. METHODS:We analyzed the outcome of 13 patients with duodenal GISTs who underwent surgical tumor resection. Either s...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-012-1432-8
更新日期:2013-04-01 00:00:00
abstract::The biomechanical properties and intestinal wall composition of left colon were studied in 4-month-old, 14-month-old, and 27-month-old male rats. The hydroxyproline content and hydroxyproline concentration in old rats were increased by 36% and 26%, respectively, compared with young rats and by 20% and 17%, respectivel...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/BF00341292
更新日期:1992-06-01 00:00:00
abstract:BACKGROUND AND AIM:Concurrent definitive treatment of underlying fistulas from infected anal glands at the time when the anorectal abscesses are drained is controversial as this is associated with a higher incidence of faecal incontinence, failure and recurrence. This meta-analysis was conducted to determine the merits...
journal_title:International journal of colorectal disease
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s00384-005-0060-y
更新日期:2006-09-01 00:00:00
abstract::Cryosurgery is one of the palliative treatment options to decrease local symptoms due to rectal carcinoma. A total of 106 patients (aged 45-92 years) underwent palliative cryosurgery for primary rectal cancer. Inclusion criteria were prohibitive surgical risk, unresectability, distant metastases, patient refusal of su...
journal_title:International journal of colorectal disease
pub_type: 临床试验,杂志文章
doi:10.1007/s003840050206
更新日期:1999-08-01 00:00:00
abstract:PURPOSE:The main operative method in familial adenomatous polyposis (FAP) patients is restorative proctocolectomy with "J"-shaped pouch and temporary loop ileostomy. The aim of the study was the analysis of the frequency of the dysplasia and inflammation in the intestinal pouch and prognosis of the clinical course in F...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-011-1241-5
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:MRI detected extramural vascular invasion (mrEMVI) is a poor prognostic factor in rectal cancer patients. The objectives of this study were to assess survival outcomes in patients with and without mrEMVI and to compare the prognostic value of mrEMVI with other rectal cancer features. METHODS:In a Dutch high...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-020-03632-9
更新日期:2020-10-01 00:00:00
abstract:PURPOSE:Symptomatic infection with Clostridium difficile is strongly linked to antibiotic use and rates are higher for colorectal surgery. In February 2015, trust policy for antibiotic prophylaxis of ileostomy reversal surgery was changed from three doses of metronidazole plus cefuroxime to single-dose metronidazole, i...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-016-2725-0
更新日期:2017-05-01 00:00:00
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journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/BF00341394
更新日期:1991-11-01 00:00:00
abstract:PURPOSE:Ileal pouch-anal anastomosis (IPAA) has been established as the procedure of choice for patients who require excision of the colon and rectum for familial adenomatous polyposis and ulcerative colitis. The requirement for proximal stomal diversion in IPAA is controversial. OBJECTIVES:To compare post-operative o...
journal_title:International journal of colorectal disease
pub_type: 杂志文章,评审
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更新日期:2021-01-04 00:00:00
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pub_type: 杂志文章
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更新日期:2017-11-01 00:00:00
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journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-011-1341-2
更新日期:2012-03-01 00:00:00
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更新日期:2020-05-01 00:00:00
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journal_title:International journal of colorectal disease
pub_type: 杂志文章
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更新日期:2008-02-01 00:00:00
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journal_title:International journal of colorectal disease
pub_type: 杂志文章,多中心研究
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更新日期:2018-10-01 00:00:00
abstract::The aim of this study was to develop a method by which rectal and colonic activity could be examined during defaecation under physiological conditions, in order to evaluate whether the colon plays a role in defaecation. Subjects presented to the Nuclear Medicine department on the day following ingestion of oral In-111...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/BF00341204
更新日期:1995-01-01 00:00:00
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journal_title:International journal of colorectal disease
pub_type: 杂志文章
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更新日期:2018-04-01 00:00:00
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journal_title:International journal of colorectal disease
pub_type: 杂志文章
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更新日期:2017-11-01 00:00:00
abstract:PURPOSE:Stage II colon cancer (CC) represents a challenging scenario for the choice of adjuvant chemotherapy; here, histologic factors need to be weighed up to establish the risk of recurrence. Tumor budding (TB) has recently been indicated as a confident predictor of clinical outcome in CC. Likewise, the presence of p...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
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更新日期:2019-05-01 00:00:00
abstract::Although scintigraphic pelvic pouch emptying scans have been used to evaluate neorectal function in patients who have undergone colectomy, mucosal proctectomy, and ileoanal pouch anastomosis, previous reports have not documented the reliability of this test in measuring pouch volume and emptying. Thus, this study was ...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/BF00703957
更新日期:1991-02-01 00:00:00