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Middle East Journal of Digestive Diseases، جلد ۱۶، شماره ۴، صفحات ۲۲۵-۲۲۹
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چکیده فارسی مقاله
کلیدواژه‌های فارسی مقاله
عنوان انگلیسی Outcome of Selective Non-Diverting Low Anterior Resection after Neoadjuvant Chemoradiotherapy and Curative Surgery for Proximal Rectal Cancer: a Prospective Case Series
چکیده انگلیسی مقاله Background: Low anterior resection (LAR) is the gold standard for curative cancer treatment in the middle and upper rectum. In radically operated patients, the local recurrence rates with total mesorectal excision (TME) after 5 and 10 years was <10%, with 80% in 5 years survival. Anastomotic leakage (AL) affects 4–20% of patients who underwent LAR. Based on some studies, there is a risk reduction of symptomatic AL after LAR and the need for reoperation in patients with a defunctioning stoma (DS), also known as diverting stoma. Ileostomy has many complications, such as skin irritation and leakage, dehydration, obstruction, and parastomal hernia. Considering the complications of defunctioning loop-ileostomy (DLI) we designed this study to evaluate non-inserting stoma in a particular group of patients. Methods: This retrospective cohort case series study utilized data of 20 patients with rectal adenocarcinoma with lesion >7 cm from anal verge in rectoscopy who underwent LAR after 28 sessions of chemoradiotherapy and 6 weeks of rehabilitation. All of the patients matched our criteria, so DLI was not performed on any of them. Results: Among our 20 patients, four AL were happened (20%). C-reactive protein (CRP) on post-operation day (POD) six was valuable. Computed tomography (CT) scan was not used as a reliable modality in our study. In all patients with positive AL, magnetic resonance imaging (MRI) was useful and reported correctly, and direct vision of the anastomosis site by rigid rectoscopy was not safe enough to make decisions about it. Discussion: The leakage rate was not far from the average leakage rate in other studies. Then it seems it is possible to forget about defuctationg loop stoma (DLS) in safe cases to reduce the stoma complications. Due to our restricted case selection and our close observation protocol, we had no significant complications compared to other studies. According to this study, not inserting stoma in suitable cases with restricted protocol selection is possible, and the leakage rate is not higher in comparison with patients with stoma.
کلیدواژه‌های انگلیسی مقاله Low anterior resection (LAR), Defunctioning stoma (DS), Anastomotic leakage (AL), Defuctationg loop stoma (DLS)
نویسندگان مقاله | Aidin Yaghoobi Notash
General Surgeon,Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran


| Ehsan Sadeghian
General Surgeon,Department of Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran


| Ehsan Sobhanian
Department of Colorectal Surgery, Colorectal Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran


| Behnam Behboudi
Department of Colorectal Surgery, Colorectal Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran


| Seyed Mohsen Ahmadi Tafti
Department of Gynecology, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran


| Zahra Moghimi
Department of Colorectal Surgery, Colorectal Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran


| Amir Keshvari
Department of Colorectal Surgery, Colorectal Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran


| Mohammad Sadegh Fazeli
Department of Colorectal Surgery, Colorectal Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran


| Mohammad Reza Keramati


نشانی اینترنتی http://mejdd.org/index.php/mejdd/article/view/3185
فایل مقاله فایلی برای مقاله ذخیره نشده است
کد مقاله (doi) 10.15171/middle east j di.v16i4.3185
زبان مقاله منتشر شده en
موضوعات مقاله منتشر شده
نوع مقاله منتشر شده Original Article
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