[Protective stoma after deep anterior rectal resection: pro].
There is still controversy about the necessity of a diverting stoma after deep anterior resection with total mesorectal excision for rectal cancer. Recent results of randomized controlled trials and from systematic reviews have improved the currently available data. A significant benefit was shown for patients with diverting stoma in terms of clinically relevant anastomotic leakage and re-operation rates. The influence on mortality is not as clear. However, analysis of the data of 19 prospective studies within a systematic review including more than 9,000 patients, revealed a significant benefit for stoma creation. Furthermore, the rate of patients with stoma 5 years after primary resection was lower in the group of patients with diverting stoma. The purpose of this manuscript is to show the necessity of a diverting stoma based on the currently available data.
Ulrich
A
A
Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Ruprecht-Karls-Universität, Heidelberg, Deutschland. alexis.ulrich@med.uni-heidelberg.de
Weitz
J
J
Büchler
M W
MW
D003125:Colostomy / Q000523:psychology; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D010538:Peritonitis / Q000517:prevention & control / Q000523:psychology / Q000601:surgery; D011183:Postoperative Complications / Q000517:prevention & control* / Q000523:psychology / Q000601:surgery; D011788:Quality of Life / Q000523:psychology; D016032:Randomized Controlled Trials as Topic; D012007:Rectum / Q000601:surgery*; D012086:Reoperation; D012307:Risk Factors; D013529:Surgical Wound Dehiscence / Q000517:prevention & control / Q000523:psychology / Q000601:surgery