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Protective ileostomy for patients with T3 and T4 rectal cancer before neoadjuvant therapy

George Dejeu, Adrian Maghiar, Octavian Maghiar, Dan Ciurtin, Marius Sfirlea. Spital Pelican

We started using protective ileostomy for the patients that were diagnosed with T3 and T4 rectal cancer before neoadjuvant therapy in the past 24 months, looking at the effect this had on the readmision for intestinal occlusion of those patients during the course of the oncologic treatment before surgery. Taking into account two groups of patients, on a case match basis, we matched the last 30 patients we had diagnosed with T3 and T4 low rectal cancer patients, that had an ileostomy put before the start of neoadjuvant therapy to 30 patients of the same metrics besides the ileostomy from 3 years ago. The 2 groups were no different in female/male composition, age, tumor grade, comorbidities, chronic treatment, neoadjuvant treatment type. Our findings show that the number of patients that could not go through with the neoadjuvant therapy went down from 18% to 7,5%. With the number of patients that did not finally get the surgical treatment (for different reasons, that were not discussed in this present study) rising from 78% to 85%. Both statistically significant. Moreover, the most important finding in our opinion is the reduction in the need for readmission on a surgical ward from 32% to 12% of patients included in the study, and reduction of the readmission stay from a average of 4 days to 2 in the ileostomy group. We continue to study the effect of this on patients with T3 and T4 low rectal cancer patients, considering the need to apply this technique to all patients with low rectal cancer (we use a 100% ileostomy technique for all patients with low rectal cancer resection with anastomosis in our clinic, using the transanal, laparoscopic or open technique for the surgery).


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 95933

Program Number: P357

Presentation Session: Poster Session (Non CME)

Presentation Type: Poster

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Post Views: 14

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