| Diverting stoma after low anterior resection: more arguments in favor. | |
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MedLine Citation:
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PMID: 19333040 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: The necessity of a protective stoma in patients undergoing low anterior resection with total mesorectal excision for primary rectal cancer is discussed controversially. We conducted a randomized, controlled, pilot-study to evaluate the need for diverting ileostomy in patients undergoing low anterior resection [NCT00457327]. METHODS: Forty patients after elective sphincter-saving low anterior resection were eligible for intraoperative randomization. The primary objective of this trial was to demonstrate similar risks after the resection with both techniques. A priori stopping rules were defined for early termination of the trial. RESULTS: Between July 4, 2006 and March 12, 2007, a total of 41 patients were screened and 34 patients were randomized. Eighteen patients were randomized to the stoma group and 16 patients to the nonstoma group The symptomatic anastomotic leakage rate was significantly higher in the nonstoma group (37.5 percent) than in the stoma group (5.5 percent, P = 0.02). In all six cases in the nonstoma group, reoperations were necessary. The study was stopped after 34 patients were included. A meta-analysis of the available data confirmed the value of a protective ostomy for patients undergoing low anterior resection. CONCLUSIONS: The data demonstrate a high risk for patients undergoing low anterior resection without diverting ileostomy. |
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Authors:
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Alexis B Ulrich; Christoph Seiler; Nuh Rahbari; Jürgen Weitz; Markus W Büchler |
Publication Detail:
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Type: Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Diseases of the colon and rectum Volume: 52 ISSN: 1530-0358 ISO Abbreviation: Dis. Colon Rectum Publication Date: 2009 Mar |
Date Detail:
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Created Date: 2009-03-31 Completed Date: 2009-04-16 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372764 Medline TA: Dis Colon Rectum Country: United States |
Other Details:
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Languages: eng Pagination: 412-8 Citation Subset: IM |
Affiliation:
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Department of General Surgery, Visceral Surgery, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany. alexis_ulrich@med.uni-heidelberg.de |
| Data Bank Information | |
Bank Name/Acc. No.:
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ClinicalTrials.gov/NCT00457327 |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Anastomosis, Surgical / adverse effects* Colectomy* Female Humans Ileostomy* Male Middle Aged Pilot Projects Postoperative Complications / prevention & control Rectal Neoplasms / surgery* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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