title: Advantages of Early Preventive Ileostomy Closure after Total Mesorectal Excision Surgery for Rectal Cancer: An Institutional Retrospective Study of 123 Consecutive Patients.
abstract: OBJECTIVE
  Preventive ileostomy is frequently constructed to minimizethe consequences of anastomotic leakage after resection of rectal cancer. There is no consensus regarding the best timing for temporary stoma closure after proctectomy for rectal cancer. This retrospective study sought to determine whether the timing of stoma closure influenced postoperative outcomes.
  
  
  METHODS
  Subjects were 123 patients with rectal cancer undergoing laparoscopic or open total mesorectal excision surgery with preventive ileostomy from 2012 to 2015. They were divided into 2 groups according the timing of stoma closure: the standard group who had closure within 90 (60-120) days (n = 78) and the late group who had closure after 180 (150-210) days (n = 45).
  
  
  RESULTS
  There was no significant difference in operative time, operative blood loss or postoperative complications between the 2 groups. Timing of postoperative fasting and length of hospital stay was similar in both groups. Adjuvant chemotherapy was not a risk factor for postoperative complications after stoma closure.
  
  
  CONCLUSIONS
  There was no significant difference between different timings of temporary stoma closure in relation to postoperative complications. Delayed stoma closure showed no benefit in prevention of morbidity. Early closure is safe and can provide better quality of life for patients.
authors.affiliation: Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Min-Wei
authors.initials: MW
authors.lastname: Zhou
authors.forename: Zi-Hao
authors.initials: ZH
authors.lastname: Wang
authors.forename: Zong-You
authors.initials: ZY
authors.lastname: Chen
authors.forename: Jian-Bin
authors.initials: JB
authors.lastname: Xiang
authors.forename: Xiao-Dong
authors.initials: XD
authors.lastname: Gu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D017024:Chemotherapy, Adjuvant; D005215:Fasting; D005260:Female; D006801:Humans; D007081:Ileostomy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology*; D012004:Rectal Neoplasms / Q000188:drug therapy / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult
keywords: Preventive stoma; Rectal cancer; Stoma closure; Temporary stoma; Total mesorectal excision