The use of preventive stomas in surgical treatment of colorectal cancer

Abstract

Objective: to investigate the efficiency of defunctioning stomas in protection of the anastomosis formed during the resection of the colon due to cancer including the complicated colorectal cancer.Materials and methods. Retrospective analysis of treatment outcomes of patients with a colorectal cancer whom resections of the rectum were performed, treated at the V.A. Oppel Clinic of Hospital Surgery of the North-West I.I. MechnikovState Medical University from 2010 till 2015.Results. The article presents a retrospective analysis of the results of treatment of 46 patients with colorectal cancer. All the patients underwent a resection of the rectum with the formation of preventive colostoma and without it. The patients were divided into 2 matched by sex, age groups. Resection of the rectum with defunctioning stoma forming due to the complicated colorectal cancer was performed to 3 patients. Complications were found in 6 patients: 2 patients after resection of the rectum with the formation of preventive colostoma and in 4 patients after resection without its formation. Death rate was 4.3 %. 2 patients died, to both patients defunctioning stomas weren’t performed.Patients with defunctioning stomas stayed in hospital in average for 3 days longer comparing with patients whom defunctioning stoma wasn’t formed. The stoma closure operations were performed to 89.5 % of the patients with defunctioning stomas.Conclusion. The data demonstrate efficiency of defunctioning stoma in prevention of anastamosis complications in surgical treatment of colorectal cancer including complicated colorectal cancer. However, must be conducted a clear definition of indications for its formation.

Keywords

• colorectal cancer
• colostoma
• treatment
• anastomosis leakage
• complications