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[Permissibility of Stoma Closure Surgery in Patients with Colorectal Cancer Who Underwent Primary Tumor Resection
Shigeru Fujisaki1, Motoi Takashina, Ryouichi Tomita
1Dept. of Surgery, Fujisaki Hospital.
Abstract:
From 2006 to 2021, 27 patients who underwent stoma construction during colorectal cancer resection followed by stoma closure were grouped into 2 groups: Group A(7 patients with cancer)and Group B(20 patients without cancer). The male- to-female ratio were 6:1 for Group A and 13:7 for Group B. The average ages were 63.7 and 65.0 years, respectively. The ratios(Group A:Group B)of the causes for stoma construction were 5:13 for bowel obstruction due to colorectal cancer, 2:2 for abdominal wall invasion/dissemination and 0:5 for covering stoma. The causes of non-curative resection for Group A were peritoneal dissemination(4 patients), liver metastasis(1 patient), bladder infiltration(1 patient), and periaortic lymph node metastasis(1 patient). For Groups A and B, Hartmann surgery was performed in 4 and 10, colectomy and stoma construction in 3 and 5, and low anterior resection and covering stoma in 0 and 5 patients, respectively. The median time to stoma closure was 10 months for Group A and 6 months for Group B(p<0.05). There was no case of anastomotic leakage and 1 case of anastomotic stenosis(case not treated with anticancer drugs). No patient died of cancer within 1 year after stoma closure(median survival time after stoma closure was >26.0 months for Group A). Although stoma closure in patients with cancer was significantly delayed compared with patients without cancer, it was performed safely.
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