@article{4c98a75cdefb4a0bbf769ddcb6c54de8,
title = "Risk factors for non-closure of an intended temporary defunctioning stoma after emergency resection of left-sided obstructive colon cancer",
abstract = "Purpose: A substantial part (21–35%) of defunctioning stomas created during resection for colorectal cancer will never be reversed. Known risk factors for non-closure are age, peri- or postoperative complications, comorbidity, and tumor stage. However, studies performed to identify these risk factors mostly focus on rectal cancer and include both preoperative and postoperative factors. This study aims to identify preoperative risk factors for non-reversal of intended temporary stomas created during acute resection of left-sided obstructive colon cancer (LSOCC) with primary anastomosis. Methods: All patients who underwent emergency resection for LSOCC with primary anastomosis and a defunctioning stoma between 2009 and 2016 were selected from the Dutch ColoRectal Audit, and additional data were collected in the local centers. Multivariable analysis was performed to identify independent preoperative factors for non-closure of the stoma. Results: A total of 155 patients underwent acute resection for LSOCC with primary anastomosis and a defunctioning stoma. Of these, 51 patients (32.9%) did not have their stoma reversed after a median of 53 (range 7–104) months of follow-up. In multivariable analysis, hemoglobin < 7.5 mmol/L (odds ratio (OR) 4.79, 95% confidence interval (95% CI) 1.60–14.38, p = 0.005), estimated glomerular filtration rate (eGFR) ≤ 45 mL/min/1.73 m2 (OR 4.64, 95% CI 1.41–15.10, p = 0.011), and metastatic disease (OR 6.12, 95% CI 2.35–15.94, p < 0.001) revealed to be independent predictors of non-closure. Conclusions: Anemia, impaired renal function, and metastatic disease at presentation were found to be independent predictors for non-reversal of intended temporary stomas in patients who underwent acute resection for LSOCC. In patients who have an increased risk of non-reversal, the surgeon should consider a Hartmann{\textquoteright}s procedure.",
keywords = "Colorectal cancer, Defunctioning stoma, Non-closure, Obstructive colon cancer, Stoma reversal, Surgical oncology",
author = "{van Ommeren–Olijve}, {S. J.} and Burbach, {J. P.M.} and Furn{\'e}e, {E. J.B.} and H. Algera and Algie, {G. D.} and Andeweg, {C. S.} and Amelung, {F. J.} and Argillander, {T. E.} and Arron, {M. N.N.J.} and K. Arts and Aufenacker, {T. H.J.} and Bakker, {I. S.} and {van Basten Batenburg}, M. and Bastiaansen, {A. J.N.M.} and Beets, {G. L.} and Bemelman, {W. A.} and {van den Berg}, A. and {van de Beukel}, B. and Blom, {R. L.G.M.} and B. Blomberg and Boerma, {E. G.} and {den Boer}, {F. C.} and {ter Borg}, F. and Borstlap, {W. A.A.} and Bouwman, {J. E.} and A. Breijer and {van den Broek}, {W. T.} and Burghgraef, {T. A.} and M. Dam and Dekker, {J. W.T.} and {van Grevenstein}, {W. M.U.} and J. Heemskerk and Janssen, {T. L.} and Kamman, {A. V.} and Lange, {J. F.} and Nieboer, {M. J.} and P. Oomen and {van Oorschot}, N. and K. Parry and Siersema, {P. D.} and {van der Sluis}, P. and N. Smakman and D. Smit and Smits, {A. B.} and M. Tenhagen and Tolenaar, {J. L.} and {van de Ven}, {A. W.H.} and M. Vermaas and {van Vugt}, {S. T.} and Weijs, {T. J.}",
note = "Funding Information: This research project was financially supported by the Citrienfonds and Dutch Cancer Society. Acknowledgments Funding Information: H Algera, G D Algie, CS Andeweg, FJ Amelung, TE Argillander, MNNJ Arron, K Arts, THJ Aufenacker, IS Bakker, M van Basten Batenburg, AJNM Bastiaansen, G L Beets, WA Bemelman, A van den Berg, B van de Beukel, RLGM Blom, B Blomberg, EG Boerma, FC den Boer, F ter Borg, WAA Borstlap, ND Bouvy, JE Bouwman, NDA Boye, ARM Brandt-Kerkhof, HT Bransma, A Breijer, WT van den Broek, MEE Br?ker, JPM Burbach, ERJ Bruns, TA Burghgraef, ECJ Consten, RMPH Crolla, M Dam, L Daniels, JWT Dekker, A Demirkiran, KW van Dongen, SF Durmaz, A van Esch, JA van Essen, P Fockens, JW Foppen, AAW van Geloven, MF Gerhards, EA Gorter, WMU van Grevenstein, J van Groningen, IAJ de Groot-van Veen, HE Haak, JWA de Haas, P van Hagen, EE van Halsema, JTH Hamminga, K Havenga, M van Heinsbergen, B van den Hengel, E van der Harst, J Heemskerk, J Heeren, BHM Heijnen, L Heijnen, JT Heikens, M van Heinsbergen, DA Hess, N Heuchemer, C Hoff, W Hogendoorn, JE van Hooft, APJ Houdijk, N Hugen, B Inberg, TL Janssen, D Jean Pierre, WJ de Jong, ACHM Jongen, AV Kamman, JM Klaase, W Kelder, EF Kelling, R Klicks, GW De Klein, FWH Kloppenberg, JLM Konsten, LJER Koolen, V Kornmann, RTJ Kortekaas, A Kreiter, B Lamme, JF Lange, T Lettinga, D Lips, G Lo, F Logeman, YT van Loon, MF Lutke Holzik, CCM Marres, I Masselink, A Mearadji, G Meisen, AG Menon, JWS Merkus, DJLM de Mey, HCJ van der Mijle, DE Moes, CJL Molenaar, M J Nieboer, K Nielsen, GAP Nieuwenhuijzen, PA Neijenhuis, P Oomen, N van Oorschot, K Parry, KCMJ Peeters, T Paulides, I Paulusma, FB Poelmann, SW Polle, P Poortman, MH Raber, RJ Renger, BMM Reiber, R Roukema, WMJ de Ruijter, MJAM Russchen, HJT Rutten, J Scheerhoorn, S Scheurs, H Schippers, VNE Schuermans, HJ Schuijt, JC Sierink, PD Siersema, C Sietses, R Silvis, J van der Slegt, GD Slooter, M van der Sluis, P van der Sluis, N Smakman, D Smit, AB Smits, TC van Sprundel, DJA Sonneveld, C Steur, J Straatman, MC Struijs, HA Swank, AK Talsma, PJ Tanis, M Tenhagen, JAMG Tol, JL Tolenaar, L Tseng, JB Tuynman, MJF van Veen, J.V. Veld, SC Veltkamp, AWH van de Ven, L Verkoele, M Vermaas, HP Versteegh, L Verslijs, T Visser, D van Uden, WJ Vles, RJ de Vos tot Nederveen Cappel, HS de Vries, ST van Vugt, G Vugts, JA Wegdam, TJ Weijs, BJ van Wely, M Westerterp, HL van Westreenen, B Wiering, NAT Wijffels, AA Wijkmans, LH Wijngaarden, JHW de Wilt, M van de Wilt, DD Wisselink, F Wit, ES van der Zaag, DDE Zimmerman, TLR Zwols Publisher Copyright: {\textcopyright} 2020, The Author(s).",
year = "2020",
month = jun,
doi = "10.1007/s00384-020-03559-1",
language = "English",
volume = "35",
pages = "1087--1093",
journal = "International Journal of Colorectal Disease",
issn = "0179-1958",
publisher = "Springer-Verlag",
number = "6",
}