Recently, several studies have addressed the safety and feasibility of early ileostomy closure (within 2 weeks after primary surgery) and reported promising results. Therefore, patients suffering from considerable pressure are eager to close the diverting stoma after primary surgery however, there are no strict recommendations for the optimal timing of ileostomy closure. However, a diverting stoma has various adverse effects including stoma-related morbidities, physical stress, and psychological handicap, which affect the patients’ quality of life. There are some agreements among surgeons that ileostomy closure should not be performed earlier than 60-90 days. Previous studies have demonstrated that patients with a temporary diverting ileostomy were at lower risk to suffer from anastomotic leakage, peritonitis, and their associated morbidity and mortality than those without it. IntroductionĪ temporary diverting ileostomy is frequently performed on patients who have had rectal cancer surgery to protect anastomosis, particularly for rectal cancer of the middle and lower third. Temporary ileostomy closure before adjuvant chemotherapy following curative rectal cancer resection can achieve a clinical and oncological safety level equal to stoma closure during or after chemotherapy in selected patients. There was no significant difference in disease-free survival ( ) and overall survival ( ) between the three groups. No significant differences were observed in operative time, postoperative hospital stay, postoperative complications, total adjuvant chemotherapy cycles, and low anterior resection syndrome scores among the three groups. A total of 225 patients were evaluated for eligibility, and 132 were finally selected and divided into 3 groups (24 in Group I, 53 in Group II, and 55 in Group III). Patients undergoing ileostomy closure before adjuvant chemotherapy (Group I) were compared to patients undergoing closure during (Group II) and after (Group III) adjuvant chemotherapy. Patients diagnosed with rectal adenocarcinoma who underwent low anterior resection and temporary loop ileostomy during May 2015 and September 2019 were retrospectively evaluated. The aim of this study is to investigate the clinical and oncological outcomes of ileostomy closure before, during, and after adjuvant chemotherapy following curative rectal cancer resection. The optimal timing of temporary ileostomy closure with respect to the time of adjuvant chemotherapy following sphincter-saving surgery for rectal cancer remains unclear.
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