Abstract:
BACKGROUND:Diverting stomata (DS) have been shown to mitigate the clinical impact of anastomotic leakage (AL) but not without complications, and their routine use remains a matter of international debate. The objective of this study was to examine the association between stomata and the clinical consequences of AL. METHODS:This was a nationwide retrospective cohort study including all patients suffering from AL after low anterior resection from 2001 to 2010. RESULTS:Four thousand sixty-three patients were treated in the period of whom 581 (11.9%) developed AL. In case of AL, patients without a diverting stoma had a slightly higher 90-day mortality rate (13.5% versus 8.7%, p = 0.089). Patients suffered more complications due to AL, both surgical (52% versus 28%, p < 0.001) and non-surgical (48% versus 35%, p = 0.004) with a higher Clavien-Dindo score. Twenty percent of patients developed stoma-related complications prior to stoma reversal. Mortality related to stoma reversal was 2.4%. Factors associated with a risk of a permanent stoma were age (HR 1.04, 95% CI 1.01-1.08), blood transfusion during primary surgery (HR 2.35, 95% CI 1.16-4-78), conserved anastomosis after AL (HR 0.019, 95% CI 0.009-0.04), and a diverting stoma fashioned at the index operation (HR 0.50, 95% CI 0.26-0.97). CONCLUSION:The use of diverting stomata during low anterior resection mitigates the clinical impact of AL. However, this benefit needs to be balanced against the risk of stoma-related complications, seen in 20%, and mortality with stoma reversal (2.4%). Where practical, the decision to divert should be made pre-operatively in a multidisciplinary setting.
journal_name
Int J Colorectal Disjournal_title
International journal of colorectal diseaseauthors
Schlesinger NH,Smith Hdoi
10.1007/s00384-020-03625-8subject
Has Abstractpub_date
2020-10-01 00:00:00pages
1903-1910issue
10eissn
0179-1958issn
1432-1262pii
10.1007/s00384-020-03625-8journal_volume
35pub_type
杂志文章abstract:BACKGROUND AND AIMS:A 5-bp insertion-deletion (indel) polymorphism in the promoter of interferon regulatory factor 5 (IRF5) has been associated with inflammatory bowel diseases (IBD). This polymorphism generates an additional binding site for the transcription factor SP1 and has been shown to augment the expression of ...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-010-0874-0
更新日期:2010-05-01 00:00:00
abstract:OBJECTIVES:Inflammation is an important driver of abdominal pain in inflammatory bowel disease (IBD). However, some patients in remission still experience pain. We aimed to identify risk factors associated with abdominal pain in quiescent IBD (QP-IBD) and to characterize differences from patients with active disease ex...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-020-03727-3
更新日期:2021-01-01 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:PURPOSE:Several studies compared the outcomes of laparoscopically completed colorectal resections (LCR) to those requiring conversion to open surgery (COS). However, a comparative analysis between COS patients and patients undergoing planned open surgery (POS) would be useful to clarify if the conversion can be conside...
journal_title:International journal of colorectal disease
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s00384-015-2324-5
更新日期:2015-11-01 00:00:00
abstract::It has been suggested that perineal descent causes puborectalis neuropathy. To elucidate this, perineal descent was measured on standard proctograms and prolongation of mean motor unit potential duration was used as the index of denervation of the external sphincter and puborectalis in 9 male and 18 female patients wi...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/BF01648413
更新日期:1986-04-01 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:Fecal incontinence (FI) is a debilitating condition that can be socially and personally incapacitating. A broad range of treatment options, often stepwise, are available, depending on severity. This prospective study reports a large single-centered series of patients who have benefited of temperature-controlled...
journal_title:International journal of colorectal disease
pub_type: 临床试验,杂志文章
doi:10.1007/s00384-008-0514-0
更新日期:2008-10-01 00:00:00
abstract:PURPOSE:Large bowel obstruction and megacolon formation secondary to complicated diverticulitis is rare. METHODS:We present a case of an 84-year-old woman surviving large bowel obstruction and mega-megacolon formation secondary to complicated diverticulitis, with an impressive presentation of abdominal distention. RE...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-020-03642-7
更新日期:2020-08-01 00:00:00
abstract:INTRODUCTION:Prior international datasets have demonstrated equivocal results in the rate of surgical procedures for the treatment of Crohn's disease (CD) following the introduction of biologic medications. The first biologic medication licensed for use in the Republic of Ireland (ROI) was infliximab in 1999. The curre...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-013-1698-5
更新日期:2013-10-01 00:00:00
abstract:PURPOSE:Surgical consultation is recommended for all patients with fulminant Clostridioides difficile infection (CDI). If surgery is required, total abdominal colectomy (TAC) is most commonly performed. However, diverting loop ileostomy and colonic lavage have been recently developed as a potential colon-sparing approa...
journal_title:International journal of colorectal disease
pub_type: 杂志文章,meta分析
doi:10.1007/s00384-019-03447-3
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND AND AIMS:This pilot study examines whether single-dose intravenous metronidazole preoperatively is at least as effective as a broad-spectrum multi-drug regimen in preventing infection-related wound complications following excision of pilonidal sinuses with primary closure. PATIENTS AND METHODS:A double-blin...
journal_title:International journal of colorectal disease
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s00384-002-0416-5
更新日期:2002-09-01 00:00:00
abstract::The mechanisms of the antineoplastic effect of nonsteroidal anti-inflammatory drugs (NSAIDs) still are unknown, but the induction of apoptosis is one of the possible mechanisms. We attempted to demonstrate the role of mitogen-activated protein (MAP) kinases, generally considered to be important mediators of proliferat...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s003840100301
更新日期:2001-06-01 00:00:00
abstract:BACKGROUND:The prognostic impact of isolated lymphovascular invasion (LVI) after radical resection of rectal cancer is controversially discussed. However, it could be relevant to decide for an adjuvant treatment. AIM:The aim of the analysis was, based on the data of an observational study, to determine the prognostic ...
journal_title:International journal of colorectal disease
pub_type: 杂志文章,多中心研究
doi:10.1007/s00384-006-0220-8
更新日期:2007-07-01 00:00:00
abstract:INTRODUCTION:Cancer survival is related not only to primary malignancy but also to concomitant nonmalignant diseases. The aim of this study was to investigate the prognostic capacity of four comorbidity indices [the Charlson comorbidity index (CCI), the Elixhauser method, the National Institute on Aging (NIA) and Natio...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-014-1972-1
更新日期:2014-09-01 00:00:00
abstract:PURPOSE:Although the regional lymph node status is essential for staging of colorectal cancer, the importance of the total number of collected nodes remains controversial. Our aim was to examine the impact of the metastatic lymph node ratio (LNR) on the survival of patients with Dukes C colorectal cancer. METHODS:All ...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-011-1340-3
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:Colorectal cancer (CRC) is the third most frequent cancer diagnosed in men and the second in women. Laparoscopic surgery has been a technical revolution in colorectal surgery, facilitating a better recovery of patients with lower morbidity and better esthetic results, compared to traditional surgery via lapa...
journal_title:International journal of colorectal disease
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00384-018-3157-9
更新日期:2018-11-01 00:00:00
abstract:PURPOSE:The impact of chemotherapy (CTx) on morbidity after liver resection for colorectal metastases (CRC-LM) has been increasingly investigated during recent years. Biologic agents like bevacizumab (BEV) or cetuximab (CET) are now added as "targeted therapy" (TT), also in neoadjuvant settings. Initial series could de...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-011-1360-z
更新日期:2012-05-01 00:00:00
abstract:INTRODUCTION:Visceral pain is a symptom reported by over 70% of inflammatory bowel disease (IBD) sufferers. So far, a single, specific cause of this debilitating state has not been established. Chronic pain is one of the most important factors decreasing the quality of life in IBD course. Concurrently, management of pa...
journal_title:International journal of colorectal disease
pub_type: 杂志文章,评审
doi:10.1007/s00384-018-3218-0
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:In acute or chronic inflammatory bowel disease (IBD) interferon gamma (IFNgamma) is still considered to be an important pro-inflammatory mediator. In the present study we investigated the impact of IFNgamma on interleukin-8 (IL-8) production as a read-out for cell activation in intestinal epithelial cell (IE...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-003-0570-4
更新日期:2004-09-01 00:00:00
abstract:BACKGROUND AND AIMS:As integral membrane proteins, claudins form tight junctions together with occludin. Several claudins were shown to be up-regulated in various cancer types. We performed an expression analysis of genes encoding tight junction proteins to display differential gene expression on RNA and protein level ...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-006-0197-3
更新日期:2007-06-01 00:00:00
abstract:PURPOSE:TNF blockers are approved for intravenous or subcutaneous systemic therapy of many chronic inflammatory diseases. As it is not possible to achieve a sufficient local clinical improvement through systemic therapy in every patient, diverse approaches of topical therapy using TNF blockers have been investigated in...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-017-2860-2
更新日期:2017-09-01 00:00:00
abstract::440 patients were prospectively enrolled in a randomized, multicenter trial to compare 4 types of manual (84 interrupted end-to-end, 77 continuous end-to-end, 82 interrupted end-to-side, and 91 continuous end-to-side) (polyglycolic derived suture) and 1 type of stapled (106 side-to-side with GIA+TA devices) ileocoloni...
journal_title:International journal of colorectal disease
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1007/BF00341273
更新日期:1993-03-01 00:00:00
abstract:PURPOSE:Long-term outcomes of patients with T1 colorectal carcinoma (CRC) treated by endoscopic resection (ER) or surgical resection are unclear in relation to the curative criteria in the Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines. The aim of this study was to retrospectively compare the lo...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-015-2473-6
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND AND AIMS:Accurate, long-term risk predictors for colorectal cancer development in patients with sporadic adenomas are lacking. We sought to validate biomarkers predictive of metachronous colorectal cancer (mCRC) in patients with sporadic colorectal adenomas, using 374 consecutive patients from a large define...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-007-0424-6
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:As angiogenesis is one of the key steps in tumor growth, invasion, and metastasis, antiangiogenic therapy is supposed to be an attractive approach for antitumor treatment. We investigated the cytotoxic, anti-adhesive, and anti-invasive effects of angiostatin in vitro and on intraperitoneal tumor growth in a ...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-005-0040-2
更新日期:2006-05-01 00:00:00
abstract:PURPOSE:This study aims to explore the influence of chemoradiation treatment (CRT) on rectal cancer nodes and to generate hypotheses why nodal restaging post-CRT is more accurate than at primary staging. METHODS:Thirty-nine patients with locally advanced rectal cancer underwent MRI pre- and post-CRT. All visible mesor...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-016-2576-8
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Collagenous colitis is a chronic inflammatory bowel disease of unknown origin. In some cases of collagenous colitis, histomorphological features are comparable to other inflammatory bowel diseases. AIM:To assess functional NOD2/CARD15 polymorphisms for the susceptibility to collagenous colitis in a case-con...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-006-0158-x
更新日期:2007-04-01 00:00:00
abstract:INTRODUCTION:Matrix metalloproteinases (MMPs) have repeatedly been shown to play a very active role in extracellular matrix degradation associated with tumor invasion and metastasis. Tissue inhibitors of MMPs (TIMPs) are well-known for their ability to inhibit MMP activity thereby inhibiting malignant progression. Inos...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-012-1445-3
更新日期:2012-11-01 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:BACKGROUND AND AIMS:Despite the excellent results published on circular stapled mucosectomy (CSM), there is still some concern about the application of PPH-33 in the advanced haemorrhoidal disease, where a major prolapse may lead to insufficient resection and ensuing early recurrence. This study is aimed at comparing t...
journal_title:International journal of colorectal disease
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00384-004-0720-3
更新日期:2006-01-01 00:00:00