Diverting Ostomies and their Complications in Mechanical Colorectal Anastomosis for Rectum Cancer: Retrospective Study

INTRODUCTION: Anastomotic leakage after low anterior resection is the most serious complication and increases the morbidity and mortality rates and prolonges length of stay. In this study, the effectiveness and safety of diverting ostomies in colorectal anastomosis was compared retrospectively. METHODS: The charts of all patients with diverting ostomies operated with extraperitoneal colorectal or coloanal anastomosis electively due to rectal adenocarcinoma between 2005-2010 were examined retrospectively. RESULTS: A total of 101 patients were included in the study. Twentynine (28.7%) patients were given neoadjuvant chemoradiotherapy (NAKRT). Diverting ostomy was applied to 33 of the patients (32.7%) in the study group. Diverting ileostomy was performed to 33 (93.9%) of these patients, colostomy in the remaining two. Diverting ostomy was applied to 14 of 29 patients (48.2%) treated with NAKRT (p = 0.03). While the diverting ostomy was applied in 31 patients with BMI ≥25, it was used only in two patients with BMI <25 (p = 0.0001). Surgical site infection was the most frequent complication in 24 patients (23.8%). Stoma related complications were observed in 23 patients (69.6%). Additional treatments for dehydration were needed in 4 (12.2%) patients. Parastomal skin infections were observed in 14 of 31 patients (45%) with ileostomy DISCUSSION AND CONCLUSION: In this series of patients, the diverting ostomy applications were found to Orijinal Çalışma 304 Adress for correspondence: Angora Evleri Ressamlar Caddesi F6 Blok Daire 8 Beysukent 06800 Ankara Türkiye e-mail: niyazikaraman@hotmail.com Available at www.actaoncologicaturcica.com Copyright ©Ankara Onkoloji Hastanesi be more frequent in patients with BMI ≥ 25 and treated with NAKRT. In this series of patients, the most common stoma complications were; skin irritations (42.4%), dehydration (12.1%), stoma bleeding (6.1%), mucocutaneous dehiscence (6.1%) and the need for stoma revision (3%). In terms of these complications care should be taken in patients undergoing diverting ostomy.