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Does a defunctioning stoma affect anorectal function after low rectal resection? Results of a randomized multicenter
Rickard Lindgren1, Olof Hallböök, Jörgen Rutegård
1Department of Surgery, Örebro University Hospital, Örebro, Sweden. rickard.lindgren@orebroll.se
Diseases of the Colon and Rectum
|May 10, 2011
Summary
A temporary defunctioning stoma did not impact anorectal function one year after low anterior resection surgery. Most patients experienced some rectal dysfunction but preferred it over a permanent stoma.
Area of Science:
- Colorectal surgery outcomes
- Anorectal physiology research
- Patient-reported functional assessments
Background:
- Low anterior resection (LAR) for rectal cancer frequently leads to impaired anorectal function.
- Numerous factors influence functional outcomes post-LAR, with some remaining unidentified.
Purpose of the Study:
- To evaluate the impact of a temporary defunctioning stoma on anorectal function.
- To assess functional outcomes one year after patients have been stoma-free post-LAR.
Main Methods:
- Multicenter randomized controlled trial involving 21 Swedish hospitals.
- Patients undergoing LAR for rectal adenocarcinoma were randomized to receive a defunctioning stoma or no stoma.
- Anorectal function was assessed via questionnaire at 12 months post-stoma reversal, covering stool frequency, urgency, and incontinence.
Main Results:
- 181 patients completed the questionnaire (90 stoma group, 91 no-stoma group).
- No significant differences were observed in stool frequency, medication need, evacuation difficulties, incontinence, or well-being between groups.
- Inability to defer defecation was reported by 35% in the stoma group vs. 25% in the no-stoma group (P = .15).
Conclusions:
- A temporary defunctioning stoma does not significantly alter anorectal function one year after reversal in patients who underwent LAR.
- Despite impaired function in many patients, the majority preferred their condition over a permanent stoma.
- Further research is needed as this study analyzed secondary endpoints without a pre-study power calculation.
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