title: Combined stoma reversal and liver resection: a matched case-control study.
abstract: BACKGROUND
  Stoma reversal can be performed during liver resection (LR) in patients with colorectal liver metastases (CRCLM) whose primary colorectal tumor has been previously resected with a diverting loop ileostomy. This combined procedure is reputed to be associated with an increased morbidity. This study investigates the impact of simultaneous loop ileostomy closure (LIC) on the postoperative outcome of LR for CRCLM.
  
  
  METHODS
  From November 1996 to April 2012, 408 patients who underwent LR for CRCLM were retrospectively studied from a prospective database. Patients who underwent simultaneous LR and LIC were matched for the type of the main liver procedure, the use of preoperative chemotherapy and the need for greater than or equal to 6 cycles of preoperative chemotherapy with LR only patients. Intraoperative and postoperative complications were recorded and compared.
  
  
  RESULTS
  Twenty-four patients (6%) with simultaneous LR and LIC were matched with 72 patients with LR only. Both groups were comparable for patients' demographics and intraoperative findings. Liver related (P = .957) and overall postoperative morbidity (P = .643) rates did not differ between groups.
  
  
  CONCLUSIONS
  The combined procedure appeared to be safe when strict surgical technique is used.
authors.affiliation: Department of Digestive Surgery, Hôpital Saint Antoine, 184 Rue du Faubourg Saint Antoine, 75012 Paris, France.
authors.forename: Renato M
authors.initials: RM
authors.lastname: Lupinacci
authors.affiliation: Department of Digestive Surgery, Hôpital Saint Antoine, 184 Rue du Faubourg Saint Antoine, 75012 Paris, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Agostini
authors.affiliation: Department of Digestive Surgery, Hôpital Saint Antoine, 184 Rue du Faubourg Saint Antoine, 75012 Paris, France.
authors.forename: Mircea
authors.initials: M
authors.lastname: Chirica
authors.affiliation: Department of Digestive Surgery, Hôpital Saint Antoine, 184 Rue du Faubourg Saint Antoine, 75012 Paris, France; Department of Digestive Surgery, UPMC - Paris University 6, Paris, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Balladur
authors.affiliation: Department of Digestive Surgery, Hôpital Saint Antoine, 184 Rue du Faubourg Saint Antoine, 75012 Paris, France.
authors.forename: Najim
authors.initials: N
authors.lastname: Chafaï
authors.affiliation: Department of Digestive Surgery, Hôpital Saint Antoine, 184 Rue du Faubourg Saint Antoine, 75012 Paris, France; Department of Digestive Surgery, UPMC - Paris University 6, Paris, France.
authors.forename: Yann
authors.initials: Y
authors.lastname: Parc
authors.affiliation: Department of Digestive Surgery, Hôpital Saint Antoine, 184 Rue du Faubourg Saint Antoine, 75012 Paris, France; Department of Digestive Surgery, UPMC - Paris University 6, Paris, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Tiret
authors.affiliation: Department of Digestive Surgery, Hôpital Saint Antoine, 184 Rue du Faubourg Saint Antoine, 75012 Paris, France; Department of Digestive Surgery, UPMC - Paris University 6, Paris, France. Electronic address: francois.paye@sat.aphp.fr.
authors.forename: François
authors.initials: F
authors.lastname: Paye
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000473:pathology; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007081:Ileostomy; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D012189:Retrospective Studies
keywords: Colorectal cancer; Diverting ileostomy; Hepatectomy; Metastasis; Morbidity