A selective decision algorithm for DS construction is needed to protect from AL and mitigate DS morbidities.Īnterior resection (AR) is considered the gold standard for the curative treatment of cancer in the middle and upper rectum. Routine DS did not decrease overall AL after AR. Multivariable analysis showed that male gender, ASA 3–4, BMI > 30 kg/m 2, and neoadjuvant therapy were independent risk factors for AL. DLI was constructed in more than 35% of high-located tumors ≥ 11 cm from the anal verge.
The statistical increase of DS from 71.6% in 2007–2009 to 76.7% in 2016–2018 did not impact the incidence of AL (9.2% and 8.2%), respectively. In addition, independent risk factors for AL were investigated by multivariable regression.
Patient characteristics, including DS status and occurrence of AL, were analyzed. MethodsĮlective patients subjected to AR in 2007–20-18 were recruited from the Swedish colorectal cancer registry (SCRCR). However, not much is known if the routine use of DS reduces the overall incidence of AL. Often a defunctioning loop-ileostomy is used, which is associated with substantial morbidity. Defunctioning stoma (DS) became the protective measure against AL. The goal of the sphincter-preserving procedure, such as AR, is vulnerable to anastomotic leak (AL) complications. Anterior resection (AR) is considered the gold standard for curative cancer treatment in the middle and upper rectum.
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