1. Long-Term Functional Outcome After Early vs. Late Stoma Closure in Rectal Cancer Surgery: Sub-analysis of the Multicenter FORCE Trial.
- Author
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Meyer VM, Bosch N, van der Heijden JAG, Kalkdijk-Dijkstra AJ, Pierie JPEN, Beets GL, Broens PMA, Klarenbeek BR, and van Westreenen HL
- Subjects
- Humans, Male, Female, Aged, Middle Aged, Postoperative Complications epidemiology, Postoperative Complications etiology, Treatment Outcome, Time Factors, Proctectomy adverse effects, Proctectomy methods, Rectal Neoplasms surgery, Quality of Life, Surgical Stomas adverse effects, Fecal Incontinence etiology
- Abstract
Purpose: The aim of this study was to assess the effect of early stoma closure on bowel function after low anterior resection (LAR) for rectal cancer., Methods: Patients participating in the FORCE trial who underwent LAR with protective stoma were included in this study. Patients were subdivided into an early closure group (< 3 months) and late closure group (> 3 months). Endpoints of this study were the Wexner Incontinence, low anterior resection syndrome (LARS), EORTC QLQ-CR29, and fecal incontinence quality of life (FIQL) scores at 1 year., Results: Between 2017 and 2020, 38 patients had received a diverting stoma after LAR for rectal cancer and could be included. There was no significant difference in LARS (31 vs. 30, p = 0.63) and Wexner score (6.2 vs. 5.8, p = 0.77) between the early and late closure groups. Time to stoma closure in days was not a predictor for LARS (R
2 = 0.001, F (1,36) = 0.049, p = 0.83) or Wexner score (R2 = 0.008, F (1,36) = 0.287, p = 0.60) after restored continuity. There was no significant difference between any of the FIQL domains of lifestyle, coping, depression, and embarrassment. In the EORTC QLQ-29, body image scored higher in the late closure group (21.3 vs. 1.6, p = 0.004)., Conclusion: Timing of stoma closure does not appear to affect long-term bowel function and quality of life, except for body image. To improve functional outcome, attention should be focused on other contributing factors., (© 2024. The Author(s).)- Published
- 2024
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