Factors associated with stoma closure after cytoreductive surgery

Am J Surg. 2024 Apr:230:47-51. doi: 10.1016/j.amjsurg.2023.11.037. Epub 2023 Nov 30.

Abstract

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.

Keywords: Cytoreductive surgery; Hyperthermic intraperitoneal chemotherapy; Ostomy reversal; Stoma closure.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols
  • Appendiceal Neoplasms* / pathology
  • Combined Modality Therapy
  • Cytoreduction Surgical Procedures
  • Female
  • Humans
  • Hyperthermia, Induced*
  • Male
  • Middle Aged
  • Ostomy*
  • Peritoneal Neoplasms* / therapy
  • Retrospective Studies
  • Survival Rate