title: Failing to reverse a diverting stoma after lower anterior resection of rectal cancer.
abstract: BACKGROUND
  A diverting stoma is an accepted adjunct to low anterior resection (LAR) for rectal cancer. However, some patients do not undergo a subsequent procedure to have the stoma reversed. We aim to determine incidence and risk factors for nonclosure of the diverting stoma.
  
  
  METHODS
  This is a retrospective study of stage I to III rectal cancer patients at a single institution having LAR with curative intent and a diverting stoma.
  
  
  RESULTS
  We studied 162 patients. Prevalence of nonclosure of the temporary stoma was 14.5% within 13 months of the index surgery. On a multivariate linear regression model, nonclosure was associated with anastomotic leak (odds ratio 9.89, 2.31 to 43.93, P < .001) and age older than 65 (odds ratio 2.76, 1.08 to 7.48, P < .036).
  
  
  CONCLUSIONS
  Prevalence of nonclosure of a diverting stoma after LAR for rectal cancer is substantial (14.5%). Patients should be counselled regarding this risk with particular attention to potential risk factors.
authors.affiliation: Department of Surgery, St Paul's Hospital, 1081 Burrard Street, Vancouver, British Columbia V6Z 1Y6, Canada.
authors.forename: Andrew
authors.initials: A
authors.lastname: Chiu
authors.affiliation: Department of Surgery, St Paul's Hospital, 1081 Burrard Street, Vancouver, British Columbia V6Z 1Y6, Canada.
authors.forename: Hong T
authors.initials: HT
authors.lastname: Chan
authors.affiliation: Department of Surgery, St Paul's Hospital, 1081 Burrard Street, Vancouver, British Columbia V6Z 1Y6, Canada.
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Brown
authors.affiliation: Department of Surgery, St Paul's Hospital, 1081 Burrard Street, Vancouver, British Columbia V6Z 1Y6, Canada.
authors.forename: Manoj J
authors.initials: MJ
authors.lastname: Raval
authors.affiliation: Department of Surgery, St Paul's Hospital, 1081 Burrard Street, Vancouver, British Columbia V6Z 1Y6, Canada. Electronic address: tphang@providencehealth.bc.ca.
authors.forename: P Terry
authors.initials: PT
authors.lastname: Phang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003125:Colostomy / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007081:Ileostomy / Q000706:statistics & numerical data*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Diverting stoma; Low anterior resection; Non-closure rates; Rectal cancer