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Use of ileostomy versus colostomy as a bridge to surgery in left-sided obstructive colon cancer: retrospective cohort study

2023; Wiley; Volume: 7; Issue: 3 Linguagem: Inglês

10.1093/bjsopen/zrad038

2474-9842

Bo P. Smalbroek, Teus J. Weijs, Lea M. Dijksman, Floris B. Poelmann, Lucas Goense, Robert R Dijkstra, N. Wijffels, Djamila Boerma, Anke B. Smits, Femke J. Amelung, Esther C. J. Consten, Thijs A. Burghgraef, Daniël A. Hess, R Roukema, Ahmet Demirkıran, Mark Tenhagen, Jennifer Straatman, Grard A. P. Nieuwenhuijzen, H.J.T. Rutten, Guusje Vugts, Bas Inberg, A Kreiter, S Scheurs, Michael F. Gerhards, R.L.G.M. Blom, M.J.A.M. Russchen, Anke van den Berg, Jan Willem T. Dekker, H. P. Versteegh, Frank W.H. Kloppenberg, Ilsalien S. Bakker, J. T. Hamminga, Joop Konsten, Maarten van Heinsbergen, Sebastiaan T. van Vugt, Johanna E. Bouwman, Joost T. Heikens, Anke van den Berg, Marijn Takkenberg, Leon J Graat, A.J.N.M. Bastiaansen, Erwin A. Gorter, J. W. S. Merkus, Evert-Jan G. Boerma, Laura J. E. R. Koolen, D Jean Pierre, E. van der Harst, Wouter Hogendoorn, Leontine H. Wijngaarden, R.T.J. Kortekaas, Marie-Chantal Struijs, N Heuchemer, Paul Fockens, Emo E. van Halsema, Wernard A. A. Borstlap, Pieter J. Tanis, Joyce Veld, Willem A. Bemelman, D D Wisselink, Audrey C. H. M. Jongen, Valérie Schuermans, Nicole D. Bouvy, C S Andeweg, J. W. Foppen, Jeroen Heemskerk, Jai Scheerhoorn, Pieter van der Sluis, Niels Smakman, Emma R.J. Bruns, Edwin S. van der Zaag, H J Schuiten, Tanja E. Argillander, Kevin Parry, Daniel J. Lips, H Algera, Pieter Poortman, C. Steur, Hilko A. Swank, Bas Lamme, Melissa N. N. Arron, Denise van Uden, Peter D. Siersema, Johannes H. W. de Wilt, L. Daniels, D J A Sonneveld, Kirstine Lykke Nielsen, Ilse Masselink, L M Lutke Holzik, Gavin Lo, Anand G. Menon, Johan F. Lange, Bob J. van Wely, Anouk Esch, Daan Moes, B M M Reuber, Bob H. M. Heijnen, I. Veen, Anthony W. H. van de Ven, C. C. M. Marres, Hester E. Haak, Maarten Vermaas, Pieter van Hagen, Henderik L. van Westreenen, J W A de Haas, Joost M. Klaase, M. J. F. van Veen, Amir Mearadji, Jos Heeren, R. Silvis, Johanna A.M.G. Tol, Charlotte J. L. Molenaar, Jeroen A. van Essen, T. Lettinga, L Verkoele, Geerard L. Beets, D. D. E. Zimmerman, Yu‐Ting van Loon, Pim J. A. Oomen, Hilbert S. de Vries, Jeanin E. van Hooft, Koen Peeters, N D A Boye, Frank ter Borg, A K Talsma, A A Wijkmans, A. A. W. van Geloven, N van Oorschot, Björn Blomberg, Wilhelmina M. U. van Grevenstein, Jip L. Tolenaar, Frank C. den Boer, Joanne C Sierink, T Paulides, Beata M. M. Reiber, B van de Beukel, Jurriaan B. Tuynman, H T Bransma, Alexandra R. M. Brandt‐Kerkhof, Mirelle Bröker, Rogier M. P. H. Crolla, Jasper van der Slegt, Ties L. Janssen, Charlotte L. Werker, Henk Jan Schuijt, M J Wiezer, K van Dongen, Verena N. N. Kornmann, Larissa Tseng, Derrick P. Smit, Colin Sietses, T. Visser, G. D. Algie, M J Nieboer, Peter A. Neijenhuis, Selim Durmaz, T H J Aufenacker, Niek Hugen, M. van Basten Batenburg, Marinke Westerterp, J van Groningen, W J de Jong, R J Renger, F. Logeman, Gerrit D. Slooter, K Arts, Johannes A. Wegdam, G Meisen, B. Wiering, H.C.J. van der Mijle, Ida Paulusma, Maria van der Sluis, Klaas Havenga, J.P.M. Burbach, Edgar J.B. Furnée, B Polle, Christiaan Hoff, Floris B. Poelmann, T L R Zwols, T.C. van Sprundel, S. Veltkamp, M. Wilt, Wouter J. Vles, Arnoud V. Kamman, H Schippers, René L. van der Hul, A Breijer, Wendy Kelder, Berber Van Den Hengel, R. Klicks, Emil F Kelling, Alexander P. J. Houdijk, Luc A. Heijnen, Fennie Wit, Mikkel Seidelin Dam, Michael R. Raber, D J L M de Mey, W. van den Broek, L Verslijs, Guus W. de Klein, Winanda M.J. de Ruijter, R de Vos tot Nederveen Cappel,

Colorectal and Anal Carcinomas

Colorectal cancer causes the majority of large bowel obstructions and surgical resection remains the gold standard for curative treatment. There is evidence that a deviating stoma as a bridge to surgery can reduce postoperative mortality rate; however, the optimal stoma type is unclear. The aim of this study was to compare outcomes between ileostomy and colostomy as a bridge to surgery in left-sided obstructive colon cancer.This was a national, retrospective population-based cohort study with 75 contributing hospitals. Patients with radiological left-sided obstructive colon cancer between 2009 and 2016, where a deviating stoma was used as a bridge to surgery, were included. Exclusion criteria were palliative treatment intent, perforation at presentation, emergency resection, and multivisceral resection.A total of 321 patients underwent a deviating stoma; 41 (12.7 per cent) ileostomies and 280 (87.2 per cent) colostomies. The ileostomy group had longer length of stay (median 13 (interquartile range (i.q.r.) 10-16) versus 9 (i.q.r. 6-14) days, P = 0.003) and more nutritional support during the bridging interval. Both groups showed similar complication rates in the bridging interval and after primary resection, including anastomotic leakage. Stoma reversal during resection was more common in the colostomy group (9 (22.0 per cent) versus 129 (46.1 per cent) for ileostomy and colostomy respectively, P = 0.006).This study demonstrated that patients having a colostomy as a bridge to surgery in left-sided obstructive colon cancer had a shorter length of stay and lower need for nutritional support. No difference in postoperative complications were found.