الفهرس | Only 14 pages are availabe for public view |
Abstract Colorectal cancer is the third leading cause of cancer deaths in the US and the third most common cancer worldwide. Most rectal cancer patients were old. According to the National Cancer Institute (NCI) statistics, Egypt has a greater prevalence among younger populations than elsewhere. Due to advances in low rectal cancer care, more patients are receiving sphincter-saving therapy. Neoadjuvant chemoradiotherapy, stapling, laparoscopic, TaTME, and robotic procedures are examples. Despite improvements in rectal cancer surgery, anastomotic leak rates remain between 10 and 15%. Leakage can be fatal. Intestinal anastomoses are often created during rectal cancer surgery and covering ileostomy. This reduces the deleterious effects of anastomotic leakage. A covering ileostomy reduces anastomotic leakages, according to a Cochrane Collaboration study. Urgent reoperation decreased. Despite its benefits, it lowers the patient’s quality of life and causes skin issues, fluid and electrolyte imbalances, and parastomal hernia. In cases where the intestinal anastomosis may be compromised, covering ileostomy is advised. Anastamotic abnormalities, anastomosis under tension, recent pelvic irradiation, ultralow anastomosis, patients over 70, and severe co-morbidities indicate a serious situation. The closing time of an ileostomy device is debatable and varies by institution. Early closure of the temporary loop ileostomy may reduce stoma morbidity and pain, but it can cause wound infection and technical issues. This study compares early and delayed stoma closure after lower anterior ressection for rectal cancer in terms of safety, leakage risk, and hospital stay. This study showed that Our study showed that there was no statistically significant difference between the two studied groups regarding age, sex, comorbidities prevalence and site and staging of tumor Regarding operative data, our study showed that no statistically significant difference was detected between both groups in type of surgery, anastomosis and operative time. As demonstrated in our study, there was no statistically significant difference between the two groups regarding complications Our study showed that both groups were followed up for 12 months postoperatively, showing slightly increased quality of life score in patients subjected to early closure than those subjected to delayed closure, with a mean of 102.13 ± 8.61 vs 96.81 ± 8.77 respectively after 2 months, 107 ± 7.38 vs 102.5 ± 6.18 after 6 months and 109.56 ± 5.74 vs 108.19 ± 4.64 after 12 months. Based on the results of simple and multiple regression analysis, none of the included factors was significantly associated with quality of life score 12 months postoperatively Likewise in multiple regression analysis, patients subjected to delayed closure had slightly lower quality of life score after 2 and 6 months than those subjected to early closure. |