| Meta-analysis of defunctioning stomas in low anterior resection for rectal cancer. | |
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MedLine Citation:
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PMID: 19358171 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: A defunctioning stoma is frequently created to minimize the impact of any subsequent anastomotic leak after a low rectal anastomosis. This review evaluates the need for routine stoma formation. METHODS: A meta-analysis was performed of randomized controlled trials (RCTs) and non-randomized studies with an interventional group evaluating the need for a defunctioning stoma after low anterior resection for rectal cancer. Primary outcomes analysed included clinical anastomotic leak rate, reoperation rate and mortality related to leak. RESULTS: Four RCTs and 21 non-randomized studies, with 11,429 patients in total, were analysed. Meta-analysis of the RCTs showed a lower clinical anastomotic leak rate (risk ratio (RR) 0.39 (95 per cent c.i. 0.23 to 0.66); P < 0.001) and a lower reoperation rate (RR 0.29 (0.16 to 0.53); P < 0.001) in the stoma group. Meta-analysis of the non-randomized studies showed a lower clinical anastomotic leak rate (RR 0.74 (0.67 to 0.83); P < 0.001), lower reoperation rate (RR 0.28 (0.23 to 0.35); P < 0.001) and lower mortality rate (RR 0.42 (0.28 to 0.61); P < 0.001) in the stoma group. CONCLUSION: A defunctioning stoma decreases clinical anastomotic leak rate and reoperation rate. It is recommended after low anterior resection for rectal cancer. |
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Authors:
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W S Tan; C L Tang; L Shi; K W Eu |
Publication Detail:
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Type: Evaluation Studies; Journal Article; Meta-Analysis; Review |
Journal Detail:
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Title: The British journal of surgery Volume: 96 ISSN: 1365-2168 ISO Abbreviation: Br J Surg Publication Date: 2009 May |
Date Detail:
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Created Date: 2009-04-14 Completed Date: 2009-04-24 Revised Date: 2009-10-28 |
Medline Journal Info:
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Nlm Unique ID: 0372553 Medline TA: Br J Surg Country: England |
Other Details:
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Languages: eng Pagination: 462-72 Citation Subset: AIM; IM |
Copyright Information:
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2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. |
Affiliation:
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Department of Colorectal Surgery, Singapore General Hospital, Singapore. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Anastomosis, Surgical
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mortality Humans Randomized Controlled Trials as Topic Rectal Neoplasms / mortality, physiopathology, surgery* Reoperation Surgical Stomas / physiology* Surgical Wound Dehiscence / surgery Treatment Outcome |
| Comments/Corrections | |
Comment In:
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Br J Surg. 2009 Sep;96(9):1094; author reply 1094
[PMID:
19672924
]
Br J Surg. 2009 Nov;96(11):1374-5; author reply 1375 [PMID: 19847849 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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