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Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan
© 2024 The Korean Society of Coloproctology
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Conflict of interest
No potential conflict of interest relevant to this article was reported.
Funding
None.
Author contributions
Conceptualization: MK; Data curation: MK; Formal analysis: MK; Investigation: MK, KH, YO, RT; Methodology: MK, SK, SM, KS, SI; Writing–original draft: MK; Writing–review & editing: KS, MT, YK, YT. All authors read and approved the final manuscript.
Additional information
This article was previously shared as a preprint on Research Square on March 11, 2021 (https://doi.org/10.21203/rs.3.rs-246835/v1), before undergoing peer review for publication in this journal.
Values are presented as median (range) or number (%).
DS, diverting stoma; POD, postoperative day.
aAccording to the Common Terminology Criteria for Adverse Events (CTCAE ver. 4.0, US National Cancer Institute) [10].
Complication | Grade | Total | |||
---|---|---|---|---|---|
1 | 2 | 3a | 3b | ||
Stoma outlet syndrome | 0 | 0 | 15 | 4 | 19 |
Electrolyte imbalance | 0 | 6 | 0 | 1 | 7 |
Peristomal dermatitis | 6 | 0 | 0 | 0 | 6 |
Mucocutaneous separation of stoma | 0 | 0 | 0 | 1 | 1 |
Total | 6 | 6 | 15 | 6 | 33 |
According to the Common Terminology Criteria for Adverse Events (CTCAE ver. 4.0, US National Cancer Institute) [10].
Characteristic | Value |
---|---|
Age (yr) | 64 (25–86) |
Sex | |
Male | 267 |
Female | 133 |
Body mass index (kg/m2) | 23.0 (14.3–34.4) |
Location | |
Rectosigmoid | 115 |
Upper rectum | 172 |
Lower rectum | 112 |
pStage | |
I | 111 |
II | 98 |
III | 120 |
IV | 23 |
Approach | |
Laparoscopic surgery | 272 |
Open surgery | 128 |
Procedure | |
Anterior resection | 55 |
Lower anterior resection | 308 |
Intersphincteric resection | 37 |
Ano-anastomotic distance (cm) | 6 (2–15) |
POC | |
No. of patients with POCs | 120 (30.0) |
Anastomotic leakage | 50 (12.5) |
Bowel obstructiona | 49 (12.3) |
Stoma-related complication | 33 (18.2) |
Postoperative hospitalization (day) | 13 (7–97) |
Reoperation | 19 (4.8) |
Mortality (within 30 days of surgery) | 1 (0.3) |
Characteristic | DS (–) group (n=247) | DS (+) group (n=153) | P-value |
---|---|---|---|
Age (yr) | 63 (25–85) | 64 (32–86) | 0.30 |
Sex | 0.08 | ||
Male | 157 | 110 | |
Female | 90 | 43 | |
Body mass index (kg/m2) | 23.0 (16.4–34.4) | 22.9 (12.3–33.9) | 0.24 |
Location | <0.01 | ||
Rectosigmoid | 107 | 8 | |
Upper rectum | 125 | 47 | |
Lower rectum | 14 | 98 | |
Preoperative treatment | 6 (2.4) | 27 (17.6) | <0.01 |
Chemoradiotherapy | 1 | 8 | |
Neoadjuvant chemotherapy | 5 | 19 | |
pStage | 0.03 | ||
I | 67 | 62 | |
II | 65 | 39 | |
III | 85 | 45 | |
IV | 18 | 7 |
Outcome | DS (–) group (n=247) | DS (+) group (n=153) | P-value |
---|---|---|---|
Procedure | <0.01 | ||
Anterior resection | 53 | 2 | |
Lower anterior resection | 194 | 114 | |
Intersphincteric resection | 0 | 37 | |
Lateral lymph node dissection | 2 (0.8) | 19 (12.4) | <0.01 |
Approach | 0.05 | ||
Laparoscopic surgery | 159 | 113 | |
Open surgery | 88 | 40 | |
Operation time (min) | 268 (145–805) | 405 (240–722) | <0.01 |
Blood loss (mL) | 30 (1–1,500) | 50 (6–770) | 0.84 |
Ano-anastomotic distance (cm) | 8 (4–15) | 4 (2–14) | <0.01 |
Stoma site | - | - | |
Ileum | 148 | ||
Colon | 3 | ||
Unclear | 2 |
Variable | DS (–) group (n=247) | DS (+) group (n=153) | P-value |
---|---|---|---|
Oral ingestion (POD) | 6 (4–41) | 4 (2–18) | 0.01 |
Complicationa | |||
Total | 57 (23.1) | 89 (58.2) | <0.01 |
Grade 1 | 6 (2.4) | 19 (12.4) | <0.01 |
Grade 2 | 34 (13.8) | 42 (27.5) | <0.01 |
Grade 3 | 17 (6.9) | 28 (18.3) | <0.01 |
Grade 3a | 5 (2.0) | 21 (13.7) | <0.01 |
Grade 3b | 12 (4.9) | 7 (4.6) | 0.90 |
Grade 4 | 0 (0) | 0 (0) | - |
Grade 5 | 0 (0) | 1 (0.7) | 0.20 |
Leakage | 27 (10.9) | 23 (15.0) | 0.31 |
Grade 1 | 0 (0) | 11 (7.2) | <0.01 |
Grade 2 | 16 (6.5) | 12 (7.8) | 0.60 |
Grade 3a | 0 (0) | 0 (0) | - |
Grade 3b | 11 (4.5) | 0 (0) | 0.01 |
Bowel obstruction | 10 (4.0) | 39 (25.5) | <0.01 |
Grade 1 | 0 (0) | 0 (0) | - |
Grade 2 | 4 (1.6) | 13 (8.5) | <0.01 |
Grade 3a | 5 (2.0) | 21 (13.7) | <0.01 |
Grade 3b | 1 (0.4) | 5 (3.3) | 0.02 |
Surgical site infection | 6 (2.4) | 3 (2.0) | 0.56 |
Grade 1 | 6 (2.4) | 2 (1.3) | 0.44 |
Grade 2 | 0 (0) | 0 (0) | - |
Grade 3a | 0 (0) | 0 (0) | - |
Grade 3b | 0 (0) | 1 (0.7) | 0.20 |
Urinary disturbance | 14 (5.7) | 11 (7.2) | 0.55 |
Grade 1 | 0 (0) | 0 (0) | - |
Grade 2 | 14 (5.7) | 11 (7.2) | 0.55 |
Grade 3a | 0 (0) | 0 (0) | - |
Grade 3b | 0 (0) | 0 (0) | - |
Hospitalization (day) | 12 (7–85) | 15 (8–97) | 0.02 |
Reoperation | 12 (4.9) | 7 (4.6) | 0.90 |
Complication | Grade | Total | |||
---|---|---|---|---|---|
1 | 2 | 3a | 3b | ||
Stoma outlet syndrome | 0 | 0 | 15 | 4 | 19 |
Electrolyte imbalance | 0 | 6 | 0 | 1 | 7 |
Peristomal dermatitis | 6 | 0 | 0 | 0 | 6 |
Mucocutaneous separation of stoma | 0 | 0 | 0 | 1 | 1 |
Total | 6 | 6 | 15 | 6 | 33 |
Values are presented as median (range), number only, or number (%). pStage, pathologic stage; POC, postoperative complication. aIncluding stoma outlet syndrome (n=19).
Values are presented as median (range), number only, or number (%). DS, diverting stoma; pStage, pathologic stage.
Values are presented as number only, number (%), or median (range). DS, diverting stoma.
Values are presented as median (range) or number (%). DS, diverting stoma; POD, postoperative day. aAccording to the Common Terminology Criteria for Adverse Events (CTCAE ver. 4.0, US National Cancer Institute) [
According to the Common Terminology Criteria for Adverse Events (CTCAE ver. 4.0, US National Cancer Institute) [