Factors associated with stoma closure after cytoreductive surgery - 18/03/24
, Sumeyye Yilmaz a, Daniel Joyce b, Robert DeBernardo c, David Liska a, Emre Gorgun a, Scott R. Steele a, Michael A. Valente aAbstract |
Background |
The rate of stoma closure after cytoreductive surgery (CRS) ± hypethermic intraperitoneal chemotherapy (HIPEC) is reportedly low. This study aimed to assess predictors of stoma reversal.
Methods |
We retrospectively analyzed all patients who underwent CRS with temporary ostomy at our center between 2009 and 2021, and compared reversed versus non-reversed patients.
Results |
Out of 625 CRS, 72 (11.5%) patients were included (median age 62 years, 65% female, 75% with HIPEC): 53 (74%) achieved stoma closure. Reversed patients had less high grade tumors, more appendiceal mucinous neoplasms, less ovarian primaries, and more loop ileostomies. The most common reason for non-reversal was disease progression or death (14 cases, 74%). At multivariate analysis, low/intermediate grade tumor differentiation was associated with higher stoma closure rate.
Conclusion |
In our study, 74% of patients achieved stoma closure after CRS with temporary ostomy. The strongest predictor of stoma closure was a low/intermediate grade tumor.
Le texte complet de cet article est disponible en PDF.Highlights |
• | In this monocentric study on stoma reversal after cytoreductive surgery (CRS) with temporary ostomy including 72 patients, reversal was achieved in 74%. |
• | The most common reason for non-reversal was disease progression or death. |
• | Patients who achieved reversal had less high-grade tumors and higher disease-free survival than non-reversed patients, while, operative time, extent of surgery, concomitant hyperthermic intraperitoneal chemotherapy and postoperative morbidity was similar. |
• | Low/intermediate grade tumor was the only predictor of stoma reversal at multivariate analysis. |
Keywords : Cytoreductive surgery, Hyperthermic intraperitoneal chemotherapy, Ostomy reversal, Stoma closure
Plan
Vol 230
P. 47-51 - avril 2024 Retour au numéro
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