Morbidity of diverting stoma during colorectal surgery for deep infiltrating endometriosis - an observational study

Mège D, Diane Mège, Clémentine Bernard, Bernard C, Pivano A, Audrey Pivano, Nho RLH, Rémy Le Huu Nho, Mathilde Aubert, Aubert M, Julie Duclos, Duclos J, Agostini A, Aubert Agostini, Nicolas Pirro, N. Pirró, Pirro N
Journal of gynecology obstetrics and human reproduction · 2022 · vol. 51(4) , pp. 102347 · doi:10.1016/j.jogoh.2022.102347 · PMID:35231644 · W4214551750
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This observational study investigated the morbidity associated with creating a diverting stoma during colorectal surgery for deep infiltrating endometriosis.

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Abstract

PURPOSE: To evaluate stoma-related complications after rectal resection and colorectal anastomosis with diverting stoma for deep infiltrating colorectal endometriosis. METHODS: All the consecutive adult women who underwent colorectal resection with low anastomosis and diverting stoma for deep infiltrating endometriosis in one center between 2013 and 2020 were retrospectively included. Stoma-related complications were retrieved during the stoma period and after stoma reversal. RESULTS: 33 patients (mean age = 32 years (±6, range=24-45 years) were included. After the first surgery, overall and surgical morbidities were observed in 42% and 30% of patients, including stoma-related complications in 3 patients (9%): high output (n = 2) and prolapse (n = 1). One patient presented with rectovaginal fistula, requiring several unplanned surgeries. No anastomotic leakage was observed. All the patients underwent stoma reversal, after mean delay of 3 months (±3, range=1-20 months). Overall morbidity after stoma closure occurred in 9 patients (27%), including 1 major morbidity (digestive bleeding). Long-term results were obtained after a mean follow-up of 21 months (±9, range=14-34 months). Four patients presented with hernia at the stoma site (12%). The cumulative rate of stoma-related complications was 45%. CONCLUSION: There is no consensus about the impact of diverting stoma after rectal resection with colorectal anastomosis for deep infiltrating colorectal endometriosis. Stoma-related complications are frequently observed but there are major in only 12% of patients. High risk patients of rectovaginal fistula and/or anastomotic leakage need to be identified to better indicate the diverting stoma, waiting for randomized trials evaluating the real impact of diverting stoma.

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Condition tags

endometriosisdie_deep_infiltrating

MeSH descriptors

Colorectal Surgery Colorectal Surgery Endometriosis Endometriosis Endometriosis Endometriosis Adult Adult Female Female Humans Humans Morbidity Morbidity Postoperative Complications Postoperative Complications Postoperative Complications Postoperative Complications Retrospective Studies Retrospective Studies

Citation neighborhood (2-hop)

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 ]

References (26)

Source provenance

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