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Increased risk of postoperative complications after delayed stoma reversal : a multicenter retrospective cohort study on patients undergoing anterior resection for rectal cancer

Munshi, Eihab LU ; Segelman, Josefin ; Matthiessen, Peter ; Park, Jennifer ; Rutegård, Martin LU ; Sjöström, Olle ; Jutesten, Henrik LU ; Lydrup, Marie Louise LU and Buchwald, Pamela LU (2025) In International Journal of Colorectal Disease 40(1).
Abstract

Purpose: Defunctioning stoma (DS) has been suggested to mitigate the consequences of anastomotic leak (AL) after low anterior resection. Stoma reversal (SR) is commonly delayed for nonmedical reasons in many healthcare systems. This study investigated the impact of the elapsed time from AR to SR on postoperative 90-day complications. The secondary aim was to explore the independent factors associated with a delayed SR. M&M: This multicenter retrospective cohort study included rectal cancer patients who underwent anterior resection (AR) and DS between 2014 and 2018. Multivariable logistic regression was used to evaluate the influence of the elapsed time from AR to SR on postoperative complications within 90 days. Results: Out of 905... (More)

Purpose: Defunctioning stoma (DS) has been suggested to mitigate the consequences of anastomotic leak (AL) after low anterior resection. Stoma reversal (SR) is commonly delayed for nonmedical reasons in many healthcare systems. This study investigated the impact of the elapsed time from AR to SR on postoperative 90-day complications. The secondary aim was to explore the independent factors associated with a delayed SR. M&M: This multicenter retrospective cohort study included rectal cancer patients who underwent anterior resection (AR) and DS between 2014 and 2018. Multivariable logistic regression was used to evaluate the influence of the elapsed time from AR to SR on postoperative complications within 90 days. Results: Out of 905 patients subjected to AR with DS, 116 (18%) patients experienced at least one postoperative 90-day complication after SR. Multivariable analysis revealed an association between the elapsed time to SR and complications within 90 days from SR (OR 1.02; 95% CI, 1.00–1.04). The association with SR complications was further highlighted in patients who experienced delayed SR > 6 months after AR (OR 1.73; 95% CI, 1.04–2.86). AL after AR and nodal disease were both related to delayed SR. Conclusion: This study demonstrated that postoperative 90-day complications are associated with the time elapsed to SR. These findings emphasize the importance of early SR, preferably within 6 months, to prevent complications.

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author
; ; ; ; ; ; ; and
author collaboration
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Anastomotic leak, Anterior resection, Defunctioning stoma, Postoperative complications, Stoma reversal complications, Stoma reversal time
in
International Journal of Colorectal Disease
volume
40
issue
1
article number
36
publisher
Springer
external identifiers
  • scopus:85218842138
  • pmid:39939486
ISSN
0179-1958
DOI
10.1007/s00384-025-04831-y
language
English
LU publication?
yes
id
a1390f19-dfca-4e6f-920b-56f25622a546
date added to LUP
2025-06-10 10:14:00
date last changed
2025-07-08 13:49:30
@article{a1390f19-dfca-4e6f-920b-56f25622a546,
  abstract     = {{<p>Purpose: Defunctioning stoma (DS) has been suggested to mitigate the consequences of anastomotic leak (AL) after low anterior resection. Stoma reversal (SR) is commonly delayed for nonmedical reasons in many healthcare systems. This study investigated the impact of the elapsed time from AR to SR on postoperative 90-day complications. The secondary aim was to explore the independent factors associated with a delayed SR. M&amp;M: This multicenter retrospective cohort study included rectal cancer patients who underwent anterior resection (AR) and DS between 2014 and 2018. Multivariable logistic regression was used to evaluate the influence of the elapsed time from AR to SR on postoperative complications within 90 days. Results: Out of 905 patients subjected to AR with DS, 116 (18%) patients experienced at least one postoperative 90-day complication after SR. Multivariable analysis revealed an association between the elapsed time to SR and complications within 90 days from SR (OR 1.02; 95% CI, 1.00–1.04). The association with SR complications was further highlighted in patients who experienced delayed SR &gt; 6 months after AR (OR 1.73; 95% CI, 1.04–2.86). AL after AR and nodal disease were both related to delayed SR. Conclusion: This study demonstrated that postoperative 90-day complications are associated with the time elapsed to SR. These findings emphasize the importance of early SR, preferably within 6 months, to prevent complications.</p>}},
  author       = {{Munshi, Eihab and Segelman, Josefin and Matthiessen, Peter and Park, Jennifer and Rutegård, Martin and Sjöström, Olle and Jutesten, Henrik and Lydrup, Marie Louise and Buchwald, Pamela}},
  issn         = {{0179-1958}},
  keywords     = {{Anastomotic leak; Anterior resection; Defunctioning stoma; Postoperative complications; Stoma reversal complications; Stoma reversal time}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{Springer}},
  series       = {{International Journal of Colorectal Disease}},
  title        = {{Increased risk of postoperative complications after delayed stoma reversal : a multicenter retrospective cohort study on patients undergoing anterior resection for rectal cancer}},
  url          = {{http://dx.doi.org/10.1007/s00384-025-04831-y}},
  doi          = {{10.1007/s00384-025-04831-y}},
  volume       = {{40}},
  year         = {{2025}},
}