Long-term stoma-related reinterventions after anterior resection for rectal cancer with or without anastomosis: population data from the Dutch snapshot study

the Dutch Snapshot Research Group

doi:10.1007/s10151-021-02543-3

Long-term stoma-related reinterventions after anterior resection for rectal cancer with or without anastomosis: population data from the Dutch snapshot study

the Dutch Snapshot Research Group

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background: The aim of this study was to analyze the stoma-related reinterventions, complications and readmissions after an anterior resection for rectal cancer, based on a cross-sectional nationwide cohort study with 3-year follow-up. Methods: Rectal cancer patients who underwent a resection with either a functional anastomosis, a defunctioned anastomosis, or Hartmann’s procedure (HP) with an end colostomy in 2011 in 71 Dutch hospitals were included. The primary outcome was number of stoma-related reinterventions. Results: Of the 2095 patients with rectal cancer, 1400 patients received an anterior resection and were included in this study; 257 received an initially functional anastomosis, 741 a defunctioned anastomosis, and 402 patients a HP. Of the 1400 included patients, 62% were males, 38% were females and the mean age was 67 years (SD 11.1). Following a primary functional anastomosis, 48 (19%) patients received a secondary stoma. Stoma-related complications occurred in six (2%) patients, requiring reintervention in one (0.4%) case. In the defunctioned anastomosis group, stoma-related complications were present in 92 (12%) patients, and required reintervention in 23 (3%) patients, in 10 (1%) of these more than 1 year after initial resection. Stoma-related complications occurred in 92 (23%) patients after a HP, and required reintervention in 39 (10%) patients in 17 (4%) of cases more than 1 year after initial resection. The permanent stoma rate was 11% and 20%, in the functional anastomosis and the defuctioned anastomosis group, respectively. The end colostomy in the HP group was reversed in 4% of cases. Conclusions: Construction of a stoma after resection for rectal cancer with preservation of the sphincter is accompanied with long-term stoma-related morbidity. Stoma complications are more frequent after a HP. Even after 1 year, a significant number of reinterventions are required.

Original language	English
Journal	Techniques in coloproctology
Early online date	26 Nov 2021
DOIs	https://doi.org/10.1007/s10151-021-02543-3
Publication status	E-pub ahead of print - 26 Nov 2021

Keywords

Anastomosis
Anterior resection
Hartmann’s procedure
Permanent stoma
Rectal cancer

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s10151-021-02543-3

Long-term-stoma-related-reinterventions-after-anterior-resection-for-rectal-cancer-with-or-without-anastomosis.pdfFinal published version, 676 KBLicence: Taverne

Cite this

@article{dcd5eaf6e0174556aa02e07d31b2bbc9,

title = "Long-term stoma-related reinterventions after anterior resection for rectal cancer with or without anastomosis: population data from the Dutch snapshot study",

abstract = "Background: The aim of this study was to analyze the stoma-related reinterventions, complications and readmissions after an anterior resection for rectal cancer, based on a cross-sectional nationwide cohort study with 3-year follow-up. Methods: Rectal cancer patients who underwent a resection with either a functional anastomosis, a defunctioned anastomosis, or Hartmann{\textquoteright}s procedure (HP) with an end colostomy in 2011 in 71 Dutch hospitals were included. The primary outcome was number of stoma-related reinterventions. Results: Of the 2095 patients with rectal cancer, 1400 patients received an anterior resection and were included in this study; 257 received an initially functional anastomosis, 741 a defunctioned anastomosis, and 402 patients a HP. Of the 1400 included patients, 62\% were males, 38\% were females and the mean age was 67 years (SD 11.1). Following a primary functional anastomosis, 48 (19\%) patients received a secondary stoma. Stoma-related complications occurred in six (2\%) patients, requiring reintervention in one (0.4\%) case. In the defunctioned anastomosis group, stoma-related complications were present in 92 (12\%) patients, and required reintervention in 23 (3\%) patients, in 10 (1\%) of these more than 1 year after initial resection. Stoma-related complications occurred in 92 (23\%) patients after a HP, and required reintervention in 39 (10\%) patients in 17 (4\%) of cases more than 1 year after initial resection. The permanent stoma rate was 11\% and 20\%, in the functional anastomosis and the defuctioned anastomosis group, respectively. The end colostomy in the HP group was reversed in 4\% of cases. Conclusions: Construction of a stoma after resection for rectal cancer with preservation of the sphincter is accompanied with long-term stoma-related morbidity. Stoma complications are more frequent after a HP. Even after 1 year, a significant number of reinterventions are required.",

keywords = "Anastomosis, Anterior resection, Hartmann{\textquoteright}s procedure, Permanent stoma, Rectal cancer",

author = "Hazen, \{S. J. A.\} and I. Vogel and Borstlap, \{W. A. A.\} and Dekker, \{J. W. T.\} and Tuynman, \{J. B.\} and Tanis, \{P. J.\} and M. Kusters and \{the Dutch Snapshot Research Group\} and Deijen, \{C. L.\} and \{den Dulk\}, M. and Bonjer, \{H. J.\} and \{van de Velde\}, \{C. J.\} and Aalbers, \{A. G. J.\} and Y. Acherman and Algie, \{G. D.\} and \{von Geusau\}, \{B. Alting\} and F. Amelung and Aukema, \{T. S.\} and Bakker, \{I. S.\} and Bartels, \{S. A.\} and S. Basha and Bastiaansen, \{A. J. N. M.\} and E. Belgers and W. Bleeker and J. Blok and Bosker, \{R. J. I.\} and Bosmans, \{J. W.\} and Boute, \{M. C.\} and Bouvy, \{N. D.\} and H. Bouwman and A. Brandt-Kerkhof and Brinkman, \{D. J.\} and S. Bruin and Bruns, \{E. R. J.\} and Burbach, \{J. P. M.\} and Burger, \{J. W. A.\} and Buskens, \{C. J.\} and \{de Mik\}, \{S. M. L.\} and \{van Duijvendijk\}, P. and Gooszen, \{J. A. H.\} and P. Hoogland and Gooszen, \{J. A. H.\} and B. Lamme and Marres, \{C. C.\} and Musters, \{G. D.\} and \{van Rossem\}, \{C. C.\} and Schreuder, \{A. M.\} and Swank, \{H. A.\} and \{van beek\}, \{S. C.\} and \{van Westreenen\}, \{H. L.\} and E. Westerduin and S. Clermonts and Coene, \{P. P. L. O.\} and C. Compaan and Consten, \{E. C. J.\} and T. Darbyshire and \{de Graaf\}, \{E. J. R.\} and \{de Groot\}, I. and \{Nederveen Cappel\}, \{R. J. L. de vos tot\} and \{de Wilt\}, \{J. H. W.\} and \{van der Wolde\}, J. and Boer, \{F. C. den\} and A. Demirkiran and M. Derkx-Hendriksen and Dijkstra, \{F. R.\} and Dunker, \{M. S.\} and Eijsbouts, \{Q. E.\} and H. Fabry and F. Ferenschild and Foppen, \{J. W.\} and Furnee, \{E. J. B.\} and Gerhards, \{M. F.\} and P. Gerven and Govaert, \{J. A.\} and \{van Grevenstein\}, \{W. M. U.\} and R. Haen and Harlaar, \{J. J.\} and E. Harst and K. Havenga and J. Heemskerk and Heeren, \{J. F.\} and B. Heijnen and P. Heres and C. Hoff and W. Hogendoorn and A. Huijbers and P. Janssen and Jongen, \{A. C.\} and Jonker, \{F. H.\} and Karthaus, \{E. G.\} and A. Keijzer and Ketel, \{J. M. A.\} and J. Klaase and Kloppenberg, \{F. W. H.\} and Kool, \{M. E.\} and R. Kortekaas and Kruyt, \{P. M.\} and Kuiper, \{J. T.\} and Lange, \{J. F.\} and T. Lettinga and Lips, \{D. J.\} and F. Logeman and \{Lutke Holzik\}, \{M. F.\} and E. Madsen and A. Mamound and I. Masselink and M. Meerdink and Menon, \{A. G.\} and Mieog, \{J. S.\} and D. Mierlo and Neijenhuis, \{P. A.\} and J. Nonner and M. Oostdijk and Oosterling, \{S. J.\} and Paul, \{P. M. P.\} and Peeters, \{K. C. M. J. C.\} and Pereboom, \{I. T. A.\} and F. Polat and P. Poortman and M. Raber and Reiber, \{B. M. M.\} and Renger, \{R. J.\} and Rutten, \{H. J.\} and A. Rutten and R. Schaapman and M. Scheer and L. Schoonderwoerd and N. Schouten and Schreurs, \{W. H.\} and Simkens, \{G. A.\} and Slooter, \{G. D.\} and Sluijmer, \{H. C. E.\} and N. Smakman and R. Smeenk and Snijders, \{H. S.\} and Sonneveld, \{D. J. A.\} and B. Spaansen and \{Spillenaar Bilgen\}, \{E. J.\} and E. Steller and Steup, \{W. H.\} and C. Steur and E. Stortelder and J. Straatman and C. Sietses and \{ten Berge\}, \{H. A.\} and \{ten hoeve\}, \{H. G.\} and \{ter Riele\}, \{W. W.\} and Thorensen, \{I. M.\} and B. Tip-Pluijm and Toorenvliet, \{B. R.\} and L. Tseng and \{van Bastelaar\}, J. and \{van de Ven\}, \{A. W. H.\} and \{van de Weijer\}, \{M. A. J.\} and \{van den Berg\}, C. and \{van den Bosch\}, I. and \{van der Bilt\}, \{J. D. W.\} and \{van der Hagen\}, \{S. J.\} and \{van der hul\}, R. and \{van der Schelling\}, G. and \{van der Spek\}, A. and \{van der Wielen\}, N. and \{van duyn\}, E. and \{van Eekelen\}, C. and \{van Essen\}, \{J. A.\} and \{van Gangelt\}, K. and \{van Geloven\}, \{A. A. W.\} and \{van kessel\}, C. and \{van Loon\}, \{Y. T.\} and \{van Rijswijk\}, A. and \{van Rooijen\}, \{S. J.\} and \{van Sprundel\}, T. and \{van Steensel\}, L. and \{van Tets\}, \{W. F.\} and S. Veltkamp and T. Verhaak and Verheijen, \{P. M.\} and L. Versluis-Ossenwaarde and S. Vijfhuize and Vles, \{W. J.\} and S. Voeten and Vogelaar, \{F. J.\} and Vrijland, \{W. W.\} and Westerterp, \{M. E.\} and M. Wetzel and K. Wevers and B. Wiering and Witjes, \{A. C.\} and Wouters, \{M. W.\} and Yauw, \{S. T. K.\} and Zeestraten, \{E. C.\} and Zimmerman, \{D. D.\} and T. Zwieten",

note = "Publisher Copyright: {\textcopyright} 2021, Springer Nature Switzerland AG.",

year = "2021",

month = nov,

day = "26",

doi = "10.1007/s10151-021-02543-3",

language = "English",

journal = "Techniques in coloproctology",

issn = "1123-6337",

publisher = "Springer-Verlag Italia",

}

TY - JOUR

T1 - Long-term stoma-related reinterventions after anterior resection for rectal cancer with or without anastomosis

T2 - population data from the Dutch snapshot study

AU - Hazen, S. J. A.

AU - Vogel, I.

AU - Borstlap, W. A. A.

AU - Dekker, J. W. T.

AU - Tuynman, J. B.

AU - Tanis, P. J.

AU - Kusters, M.

AU - the Dutch Snapshot Research Group

AU - Deijen, C. L.

AU - den Dulk, M.

AU - Bonjer, H. J.

AU - van de Velde, C. J.

AU - Aalbers, A. G. J.

AU - Acherman, Y.

AU - Algie, G. D.

AU - von Geusau, B. Alting

AU - Amelung, F.

AU - Aukema, T. S.

AU - Bakker, I. S.

AU - Bartels, S. A.

AU - Basha, S.

AU - Bastiaansen, A. J. N. M.

AU - Belgers, E.

AU - Bleeker, W.

AU - Blok, J.

AU - Bosker, R. J. I.

AU - Bosmans, J. W.

AU - Boute, M. C.

AU - Bouvy, N. D.

AU - Bouwman, H.

AU - Brandt-Kerkhof, A.

AU - Brinkman, D. J.

AU - Bruin, S.

AU - Bruns, E. R. J.

AU - Burbach, J. P. M.

AU - Burger, J. W. A.

AU - Buskens, C. J.

AU - de Mik, S. M. L.

AU - van Duijvendijk, P.

AU - Gooszen, J. A. H.

AU - Hoogland, P.

AU - Gooszen, J. A. H.

AU - Lamme, B.

AU - Marres, C. C.

AU - Musters, G. D.

AU - van Rossem, C. C.

AU - Schreuder, A. M.

AU - Swank, H. A.

AU - van beek, S. C.

AU - van Westreenen, H. L.

AU - Westerduin, E.

AU - Clermonts, S.

AU - Coene, P. P. L. O.

AU - Compaan, C.

AU - Consten, E. C. J.

AU - Darbyshire, T.

AU - de Graaf, E. J. R.

AU - de Groot, I.

AU - Nederveen Cappel, R. J. L. de vos tot

AU - de Wilt, J. H. W.

AU - van der Wolde, J.

AU - Boer, F. C. den

AU - Demirkiran, A.

AU - Derkx-Hendriksen, M.

AU - Dijkstra, F. R.

AU - Dunker, M. S.

AU - Eijsbouts, Q. E.

AU - Fabry, H.

AU - Ferenschild, F.

AU - Foppen, J. W.

AU - Furnee, E. J. B.

AU - Gerhards, M. F.

AU - Gerven, P.

AU - Govaert, J. A.

AU - van Grevenstein, W. M. U.

AU - Haen, R.

AU - Harlaar, J. J.

AU - Harst, E.

AU - Havenga, K.

AU - Heemskerk, J.

AU - Heeren, J. F.

AU - Heijnen, B.

AU - Heres, P.

AU - Hoff, C.

AU - Hogendoorn, W.

AU - Huijbers, A.

AU - Janssen, P.

AU - Jongen, A. C.

AU - Jonker, F. H.

AU - Karthaus, E. G.

AU - Keijzer, A.

AU - Ketel, J. M. A.

AU - Klaase, J.

AU - Kloppenberg, F. W. H.

AU - Kool, M. E.

AU - Kortekaas, R.

AU - Kruyt, P. M.

AU - Kuiper, J. T.

AU - Lange, J. F.

AU - Lettinga, T.

AU - Lips, D. J.

AU - Logeman, F.

AU - Lutke Holzik, M. F.

AU - Madsen, E.

AU - Mamound, A.

AU - Masselink, I.

AU - Meerdink, M.

AU - Menon, A. G.

AU - Mieog, J. S.

AU - Mierlo, D.

AU - Neijenhuis, P. A.

AU - Nonner, J.

AU - Oostdijk, M.

AU - Oosterling, S. J.

AU - Paul, P. M. P.

AU - Peeters, K. C. M. J. C.

AU - Pereboom, I. T. A.

AU - Polat, F.

AU - Poortman, P.

AU - Raber, M.

AU - Reiber, B. M. M.

AU - Renger, R. J.

AU - Rutten, H. J.

AU - Rutten, A.

AU - Schaapman, R.

AU - Scheer, M.

AU - Schoonderwoerd, L.

AU - Schouten, N.

AU - Schreurs, W. H.

AU - Simkens, G. A.

AU - Slooter, G. D.

AU - Sluijmer, H. C. E.

AU - Smakman, N.

AU - Smeenk, R.

AU - Snijders, H. S.

AU - Sonneveld, D. J. A.

AU - Spaansen, B.

AU - Spillenaar Bilgen, E. J.

AU - Steller, E.

AU - Steup, W. H.

AU - Steur, C.

AU - Stortelder, E.

AU - Straatman, J.

AU - Sietses, C.

AU - ten Berge, H. A.

AU - ten hoeve, H. G.

AU - ter Riele, W. W.

AU - Thorensen, I. M.

AU - Tip-Pluijm, B.

AU - Toorenvliet, B. R.

AU - Tseng, L.

AU - van Bastelaar, J.

AU - van de Ven, A. W. H.

AU - van de Weijer, M. A. J.

AU - van den Berg, C.

AU - van den Bosch, I.

AU - van der Bilt, J. D. W.

AU - van der Hagen, S. J.

AU - van der hul, R.

AU - van der Schelling, G.

AU - van der Spek, A.

AU - van der Wielen, N.

AU - van duyn, E.

AU - van Eekelen, C.

AU - van Essen, J. A.

AU - van Gangelt, K.

AU - van Geloven, A. A. W.

AU - van kessel, C.

AU - van Loon, Y. T.

AU - van Rijswijk, A.

AU - van Rooijen, S. J.

AU - van Sprundel, T.

AU - van Steensel, L.

AU - van Tets, W. F.

AU - Veltkamp, S.

AU - Verhaak, T.

AU - Verheijen, P. M.

AU - Versluis-Ossenwaarde, L.

AU - Vijfhuize, S.

AU - Vles, W. J.

AU - Voeten, S.

AU - Vogelaar, F. J.

AU - Vrijland, W. W.

AU - Westerterp, M. E.

AU - Wetzel, M.

AU - Wevers, K.

AU - Wiering, B.

AU - Witjes, A. C.

AU - Wouters, M. W.

AU - Yauw, S. T. K.

AU - Zeestraten, E. C.

AU - Zimmerman, D. D.

AU - Zwieten, T.

PY - 2021/11/26

Y1 - 2021/11/26

N2 - Background: The aim of this study was to analyze the stoma-related reinterventions, complications and readmissions after an anterior resection for rectal cancer, based on a cross-sectional nationwide cohort study with 3-year follow-up. Methods: Rectal cancer patients who underwent a resection with either a functional anastomosis, a defunctioned anastomosis, or Hartmann’s procedure (HP) with an end colostomy in 2011 in 71 Dutch hospitals were included. The primary outcome was number of stoma-related reinterventions. Results: Of the 2095 patients with rectal cancer, 1400 patients received an anterior resection and were included in this study; 257 received an initially functional anastomosis, 741 a defunctioned anastomosis, and 402 patients a HP. Of the 1400 included patients, 62% were males, 38% were females and the mean age was 67 years (SD 11.1). Following a primary functional anastomosis, 48 (19%) patients received a secondary stoma. Stoma-related complications occurred in six (2%) patients, requiring reintervention in one (0.4%) case. In the defunctioned anastomosis group, stoma-related complications were present in 92 (12%) patients, and required reintervention in 23 (3%) patients, in 10 (1%) of these more than 1 year after initial resection. Stoma-related complications occurred in 92 (23%) patients after a HP, and required reintervention in 39 (10%) patients in 17 (4%) of cases more than 1 year after initial resection. The permanent stoma rate was 11% and 20%, in the functional anastomosis and the defuctioned anastomosis group, respectively. The end colostomy in the HP group was reversed in 4% of cases. Conclusions: Construction of a stoma after resection for rectal cancer with preservation of the sphincter is accompanied with long-term stoma-related morbidity. Stoma complications are more frequent after a HP. Even after 1 year, a significant number of reinterventions are required.

AB - Background: The aim of this study was to analyze the stoma-related reinterventions, complications and readmissions after an anterior resection for rectal cancer, based on a cross-sectional nationwide cohort study with 3-year follow-up. Methods: Rectal cancer patients who underwent a resection with either a functional anastomosis, a defunctioned anastomosis, or Hartmann’s procedure (HP) with an end colostomy in 2011 in 71 Dutch hospitals were included. The primary outcome was number of stoma-related reinterventions. Results: Of the 2095 patients with rectal cancer, 1400 patients received an anterior resection and were included in this study; 257 received an initially functional anastomosis, 741 a defunctioned anastomosis, and 402 patients a HP. Of the 1400 included patients, 62% were males, 38% were females and the mean age was 67 years (SD 11.1). Following a primary functional anastomosis, 48 (19%) patients received a secondary stoma. Stoma-related complications occurred in six (2%) patients, requiring reintervention in one (0.4%) case. In the defunctioned anastomosis group, stoma-related complications were present in 92 (12%) patients, and required reintervention in 23 (3%) patients, in 10 (1%) of these more than 1 year after initial resection. Stoma-related complications occurred in 92 (23%) patients after a HP, and required reintervention in 39 (10%) patients in 17 (4%) of cases more than 1 year after initial resection. The permanent stoma rate was 11% and 20%, in the functional anastomosis and the defuctioned anastomosis group, respectively. The end colostomy in the HP group was reversed in 4% of cases. Conclusions: Construction of a stoma after resection for rectal cancer with preservation of the sphincter is accompanied with long-term stoma-related morbidity. Stoma complications are more frequent after a HP. Even after 1 year, a significant number of reinterventions are required.

KW - Anastomosis

KW - Anterior resection

KW - Hartmann’s procedure

KW - Permanent stoma

KW - Rectal cancer

UR - https://www.scopus.com/pages/publications/85120041732

U2 - 10.1007/s10151-021-02543-3

DO - 10.1007/s10151-021-02543-3

M3 - Article

C2 - 34837140

SN - 1123-6337

JO - Techniques in coloproctology

JF - Techniques in coloproctology

ER -

Long-term stoma-related reinterventions after anterior resection for rectal cancer with or without anastomosis: population data from the Dutch snapshot study

Abstract

Keywords

UN SDGs

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