The application of defunctioning stomas after low anterior resection of rectal cancer

Surg Today. 2019 Jun;49(6):451-459. doi: 10.1007/s00595-018-1736-6. Epub 2018 Nov 27.

Abstract

Defunctioning stomas are frequently used by colorectal surgeons after unsatisfactory anastomosis. The primary purpose of constructing a defunctioning stoma is to prevent an anastomotic leakage or to alleviate the detrimental consequences of it. However, the construction of defunctioning stomas is not free and is associated with adverse impacts on the patient. Stoma-related complications can develop in different stages and can impair a patient's quality of life. Furthermore, one in every four to six defunctioning stomas turns into a non-closure stoma. Since no definite indications for the creation of a defunctioning stoma are available, surgeons have to carefully weigh their benefits against their adverse effects. Thus, the precise selection of patients who should undergo the creation of a defunctioning stoma is of great importance, and an alternative method for preventing anastomotic leakage is needed.

Keywords: Anastomotic leakage; Defunctioning stoma; Low anterior resection; Rectal cancer.

Publication types

  • Systematic Review

MeSH terms

  • Anastomotic Leak / prevention & control*
  • Databases, Bibliographic
  • Digestive System Surgical Procedures / methods*
  • Humans
  • Organ Sparing Treatments / methods*
  • Patient Selection
  • Quality of Life
  • Rectal Neoplasms / surgery*
  • Surgical Stomas / adverse effects*