Back to Search Start Over

An Institutional Shift from Routine to Selective Diversion of Low Anastomosis in Robotic TME Surgery for Rectal Cancer Patients Using the KHANS Technique: A Single-Centre Cohort Study.

Authors :
Duhoky, Rauand
Piozzi, Guglielmo Niccolò
Rutgers, Marieke L. W.
Mykoniatis, Ioannis
Siddiqi, Najaf
Naqvi, Syed
Khan, Jim S.
Source :
Journal of Personalized Medicine; Jul2024, Vol. 14 Issue 7, p725, 13p
Publication Year :
2024

Abstract

(1) Background: In recent years, there has been a change in practice for diverting stomas in rectal cancer surgery, shifting from routine diverting stomas to a more selective approach. Studies suggest that the benefits of temporary ileostomies do not live up to their risks, such as high-output stomas, stoma dysfunction, and reoperation. (2) Methods: All rectal cancer patients treated with a robotic resection in a single tertiary colorectal centre in the UK from 2013 to 2021 were analysed. In 2015, our unit made a shift to a more selective approach to temporary diverting ileostomies. The cohort was divided into a routine diversion group treated before 2015 and a selective diversion group treated after 2015. Both groups were analysed and compared for short-term outcomes and morbidities. (3) Results: In group A, 63/70 patients (90%) had a diverting stoma compared to 98/135 patients (72.6%) in group B (p = 0.004). There were no significant differences between the groups in anastomotic leakages (11.8% vs. 17.8%, p = 0.312) or other complications (p = 0.117). There were also no significant differences in readmission (3.8% vs. 2.6%, p = 0.312) or reoperation (3.8% vs. 2.6%, p = 1.000) after stoma closure. After 1 year, 71.6% and 71.9% (p = 1.000) of patients were stoma-free. One major reason for the delay in stoma reversal was the COVID-19 pandemic, which only occurred in group B (0% vs. 22%, p = 0.054). (4) Conclusions: A more selective approach to diverting stomas for robotic rectal cancer patients does not lead to more complications or leaks and can be considered in the treatment of rectal cancer tumours. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
20754426
Volume :
14
Issue :
7
Database :
Complementary Index
Journal :
Journal of Personalized Medicine
Publication Type :
Academic Journal
Accession number :
178696134
Full Text :
https://doi.org/10.3390/jpm14070725