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Published on: March 24, 2023
[Comparison of protective colostomy vs. ileostomy in rectal cancer surgery]
José Manuel Carlos Segura-González1, Iris Isamar Tiscareño-Lozano1, Arturo García-Galicia2
1Instituto Mexicano del Seguro Social, Centro Médico Nacional "Gral de Div. Manuel Ávila Camacho", Hospital de Especialidades de Puebla, Servicio de Cirugía General. Puebla de Zaragoza, México.
Background:
Rectal cancer (RC) is the 3rd most frequent one in Mexico. Protective stoma in resection and anastomosis is controversial.
Objective:
To compare quality of life (QoL), functional capacity (FC) and complications in rectal cancer (RC) patients with low and ultralow anterior resection (LAR and ULAR) with loop transverse colostomy (LTC) versus protective ileostomy (IP).
Material And Methods:
Comparative, observational study in patients with RC and LTC (Group 1) or IP (Group 2) from 2018-2021. FC pre and postoperative, complications, hospital readmission (HR) and assessment by other specialty (AS) were assessed; QoL was assessed with EQ-5D by telephone. Student-t test, Chi-squared test, Mann-Whitney-U test were used.
Results:
Group 1: 12 patients: mean preoperative FC: ECOG 0.83, Karnofsky 91.66%; postoperative: ECOG 1, Karnofsky 89.17%. Mean postoperative QoL: index value 0.76 and health status 82.5%; HR: 25%; AS: 42%. Group 2: 10 patients: mean preoperative FC: ECOG 0.80, Karnofsky 90%; postoperative: ECOG 1.5, Karnofsky 84%. Mean postoperative QoL: index value 0.68 and health status 74%; HR: 50%; AS: 80%. Complications: 100% of sample.
Conclusion:
The differences in QoL, FC and complications between LTC and IP in RC patients operated with LAR/ULAR were not significant.
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