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New Indian Journal of Surgery

Volume  14, Issue 2, April-June 2023, Pages 63-68
 

Original Article

Clinical Prospective Study of Post-Operative Morbidity and Mortality After Low Anterior Resection with Preventive Diverting Loop Ileostomy in Patients of Rectal Cancer

Irene Halam1, Samriddh Kumar2, Abhishek Chhabra3, M.L. Dawan4, Sundar Kishor5, Sandeep Khadda6

1,2Postgraduate Final Year Student, 3,5Assistant Professor, 4Professor, Department of Surgery, Sadar Patel Medical College and PBM Hospital, Bikaner, Rajasthan, India.

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DOI: https://dx.doi.org/10.21088/nijs.0976.4747.14223.3

Abstract

Background:  Rectal cancer continues to be devastating malignancy worldwide. Faecal diversion is an important tool in the surgical management of rectal cancer. The presence of stoma may also increase the risk of complications related to stoma itself (high stoma flow, retraction, prolapse, kidney failure, skin excoriation etc.).

Aims: To measure postoperative morbidity and mortality after low anterior resection with preventive diverting loop ileostomy in patients of rectal cancer

Material and methods: This is a prospective study and was carried out between december 2021 to November 2022. Total 28 patients who underwent LAR with Diversion stoma were included according to pre-defined inclusion and exclusion criteria.

Results: Male to female ratio was 1.8:1.Mean age was 57.92±15.85 years. 1 (3.57%) patient had anastomotic leak, 3 (10.71%) had wound infection, 6 patients (21.42%) had chest infection, 1 (3.57%) patients pelvic collection, 9(32.15%) patients had electrolyte imbalance, 2(7.14%) patients had ileus. Mean hospital duration during primary surgery of patients was 11.46±2.47. Mean Post stoma closure hospital stay was 5.84 (±1.57) days. Out of total 28 patients 1(3.57%) patient died, 25 (89.29%) patients underwent subsequent stoma closure. Rest 2(7.14%) patients had their ileostomy as a permanent stoma.

Conclusions: Decision to create or not to create diversion stoma should be on case to case basis upon operating surgeon’s discretion with shared information to patient and his/her family with their involvement in decision making.


Keywords : Rectal cancer; Diversion stoma; LAR.
Corresponding Author : Manohar Dawan