title: Risk Factors for Nonclosure of a Temporary Defunctioning Ileostomy Following Anterior Resection of Rectal Cancer.
abstract: BACKGROUND
  In patients with colorectal cancer, a defunctioning ileostomy is commonly constructed to reduce anastomotic complications. However, many patients do not undergo a subsequent procedure to have their temporary stoma closed.
  
  
  OBJECTIVE
  This study investigated the incidence of nonclosure of ileostomies and identified factors associated with nonclosure.
  
  
  METHODS
  This study is a retrospective analysis of prospectively collected data.
  
  
  METHODS
  This study was conducted at a tertiary referral cancer hospital.
  
  
  METHODS
  A total of 296 patients who received anterior resection with a defunctioning ileostomy with protective intention from 2006 to 2013 were included.
  
  
  METHODS
  The primary outcomes measured were the incidence of nonclosure of ileostomy and associated risk factors.
  
  
  RESULTS
  Patients were followed for a median time of 29 months (range, 21-100 months). At the end of the study, 51 (17.2%) patients were left with a permanent ileostomy. The median time interval from the creation of a defunctioning ileostomy to closure was 192 days (range, 14-865 days). Multivariate analyses using a logistic regression model showed that metastatic diseases (OR, 0.179, p < 0.001), Charlson Comorbidity Index score >1 (OR, 0.268; p < 0.01), and complications from the index surgery (OR, 0.391; p = 0.013) were significant independent risk factors for failing to close a defunctioning ileostomy.
  
  
  CONCLUSIONS
  Although our study has a large patient cohort, it is limited by its retrospective nature. It is difficult to fully evaluate stoma complications after hospital discharge, and the prevalence may be underestimated.
  
  
  CONCLUSIONS
  One in 6 temporary ileostomies constructed during an elective anterior resection for rectal cancer was not closed. Patients should be told before the index surgery that there is a risk of nonclosure and possible complications associated with permanent ileostomy.
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Colorectal Surgery, Peking University Cancer Hospital & Institute, Beijing Cancer Hospital, Beijing, China.
authors.forename: Hong-Da
authors.initials: HD
authors.lastname: Pan
authors.forename: Yi-Fan
authors.initials: YF
authors.lastname: Peng
authors.forename: Lin
authors.initials: L
authors.lastname: Wang
authors.forename: Ming
authors.initials: M
authors.lastname: Li
authors.forename: Yun-Feng
authors.initials: YF
authors.lastname: Yao
authors.forename: Jun
authors.initials: J
authors.lastname: Zhao
authors.forename: Tian-Cheng
authors.initials: TC
authors.lastname: Zhan
authors.forename: Jin
authors.initials: J
authors.lastname: Gu
mesh_terms: D058107:Abdominal Wound Closure Techniques / Q000009:adverse effects / Q000706:statistics & numerical data; D000368:Aged; D057868:Anastomotic Leak / Q000209:etiology / Q000601:surgery; D002681:China; D003082:Colectomy / Q000379:methods; D005260:Female; D006801:Humans; D007081:Ileostomy / Q000009:adverse effects / Q000379:methods; D008297:Male; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D054047:Surgical Stomas / Q000009:adverse effects / Q000473:pathology; D017211:Treatment Failure