Influence of temporary faecal diversion on long-term survival after curative surgery for colorectal cancer

L. Meleagros, P. P. Varty, P. Delrio, P. B. Boulos

Research output: Contribution to journalArticle

Abstract

Experimental carcinogenesis is enhanced a tcoIorectal anastomoses, inhibited by proximal faecal diversion and promoted by the closure of a defunctioning stoma. The clinical relevance of these observations was investigated in a retrospective study of curative restorative resection for colorectal carcinoma. The 5-year disease-free survival rate (95 per cent confidence interval) in 122 patients with a temporary stoma (50.4 (41.1-59.7) per cent) was significantly reduced (P <0.01) compared with that in 218 with no stoma (66.8 (59.4-73.5) per cent). In patients with Dukes B tumours early stoma closure (within 3 months of resection) was associated with a worse survival (P <0.005) and a higher tumour recurrence rate (P <0.05) than in those with no stoma. Survival rates after late stoma closure were no different from those in patients with no stoma. Multivariate analysis revealed Dukes stage (P <0.0001), tumour differentiation (P = 0.02) and timing of stoma closure (P = 0.02) as independent predictors of survival. In curative surgery for colorectal cancer temporary faecal diversion confers a survival disadvantage that can be prevented by delayed closure of the stoma.

Original languageEnglish
Pages (from-to)21-25
Number of pages5
JournalBritish Journal of Surgery
Volume82
Issue number1
DOIs
Publication statusPublished - 1995

ASJC Scopus subject areas

  • Surgery

Fingerprint Dive into the research topics of 'Influence of temporary faecal diversion on long-term survival after curative surgery for colorectal cancer'. Together they form a unique fingerprint.

  • Cite this