title: Morbidity and mortality of temporary diverting ileostomies in rectal cancer surgery.
abstract: BACKGROUND
  A temporary diverting ileostomy is frequently used to reduce the consequences of a distal anastomotic leakage after total mesorectal excision in rectal cancer surgery. This surgical technique is associated with high morbidity and a not negligible mortality. The aim of this study is to evaluate the morbidity and mortality rate associated with an ileostomy and its posterior closure.
  
  
  METHODS
  Between 2001 and 2012, 96 patients with temporary diverting ileostomy were retrospectively analyzed. Morbidity and mortality were analyzed before and after the stoma closure. The studied variables included age, sex, comorbidities, time to bowel continuity restoration and adjuvant chemotherapy.
  
  
  RESULTS
  In 5 patients the stoma was permanent and another 5 died. The morbidity and mortality rates associated with the stoma while it was present were 21 and 1% respectively. We performed a stoma closure in 86 patients, 57% of whom had previously received adjuvant therapy. There was no postoperative mortality after closure and the morbidity rate was 24%. The average time between initial surgery and restoration of intestinal continuity was 152.2 days. This interval was significantly higher in patients who had received adjuvant therapy. No statistically significant difference was found between the variables analyzed and complications.
  
  
  CONCLUSIONS
  Diverting ileostomy is associated with low mortality and high morbidity rates before and after closure. Adjuvant chemotherapy significantly delays bowel continuity restoration, although in this study did not influence in the rate of complications.
authors: Servicio de Cirugía General y Aparato Digestivo, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, España. Electronic address: lucindaperezdominguez@hotmail.com.
authors: Lucinda
authors: L
authors: Pérez Domínguez
authors: Servicio de Cirugía General y Aparato Digestivo, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, España.
authors: María Teresa
authors: MT
authors: García Martínez
authors: Servicio de Cirugía General y Aparato Digestivo, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, España.
authors: Nieves
authors: N
authors: Cáceres Alvarado
authors: Servicio de Cirugía General y Aparato Digestivo, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, España.
authors: Angeles
authors: A
authors: Toscano Novella
authors: Servicio de Cirugía General y Aparato Digestivo, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, España.
authors: Antonio Pedro
authors: AP
authors: Higuero Grosso
authors: Servicio de Cirugía General y Aparato Digestivo, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, España.
authors: José Enrique
authors: JE
authors: Casal Núñez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007081:Ileostomy / Q000009:adverse effects* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000601:surgery*; D012189:Retrospective Studies
keywords: Cierre de ileostomía; Cáncer rectal; Ileostomy; Ileostomy closure; Ileostomía; Ileostomía derivativa temporal; Morbidity; Morbilidad; Rectal cancer; Temporary diverting ileostomy