Role of protective defunctioning stoma in colorectal resection for endometriosis

Belghiti J, J. Belghiti, Jérémie Belghiti, Marcos Ballester, Ballester M, Sonia Zilberman, Zilberman S, Anne Thomin, Thomin A, Chrysoula Zacharopoulou, Zacharopoulou C, Bazot M, Marc Bazot, Isabelle Thomassin-Naggara, Thomassin-Naggara I, Isabelle Thomassin‐Naggara, Emile Daraï, Daraï E, Émile Daraï
Journal of Minimally Invasive Gynecology · 2014 · vol. 21(3) , pp. 472–479 · doi:10.1016/j.jmig.2013.12.094 · PMID:24378832 · W2157958713
Non-randomised trial OA: closed CC0 ⤵ 43 in-corpus citations
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This paper investigated the role of a protective defunctioning stoma in patients undergoing colorectal resection for endometriosis.

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Abstract

STUDY OBJECTIVE: To evaluate the role of protective defunctioning stoma (PDS) on the occurrence of digestive tract complications after colorectal resection to treat endometriosis. DESIGN: Prospective cohort study (Canadian Task Force classification II-2). SETTING: University hospital. PATIENTS: All patients undergoing segmental colorectal resection to treat colorectal endometriosis with and without PDS between 2003 and 2011 at Tenon University Hospital, Paris, France. MEASUREMENTS AND MAIN RESULTS: Patients were assessed at 1, 6, and 12 months postoperatively and each year thereafter. Median follow-up was 60 months. Of 198 patients included for analysis, 53 (27%) had PDS. Overall, 15 (7.5%) digestive tract complications occurred: 9 (4.5%) rectovaginal fistulas and 6 (3%) anastomotic leakages. All rectovaginal fistulas occurred in patients with a low colorectal anastomosis (p < .001) and 88% (8 of 9) in patients with a partial colpectomy (p < .001). PDS was associated with a decrease in the number of rectovaginal fistulas in women undergoing partial colpectomy and low colorectal resection from 27% to 15%, without reaching significance (p = .4). No anastomotic leakage occurred in patients with PDS. CONCLUSION: Our results support that PDS can be omitted in patients with mid-colorectal anastomosis without partial colpectomy. In patients requiring partial colpectomy or partial colpectomy plus low colorectal anastomosis, PDS remains questionable.

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Condition tags

endometriosis

MeSH descriptors

Anastomotic Leak Endometriosis Postoperative Complications Rectovaginal Fistula Rectum Surgical Stomas Surgical Stomas Adult Adult Anastomosis, Surgical Anastomosis, Surgical Anastomosis, Surgical Anastomotic Leak Anastomotic Leak Cohort Studies Cohort Studies Endometriosis Endometriosis Female Female

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

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