Systematic Review and Meta-Analysis of the Role of Defunctioning Stoma in Low Rectal Cancer Surgery

@article{Hser2008SystematicRA,
  title={Systematic Review and Meta-Analysis of the Role of Defunctioning Stoma in Low Rectal Cancer Surgery},
  author={Norbert H{\"u}ser and Christoph W Michalski and Mert Erkan and Tibor Schuster and Robert D. Rosenberg and J{\"o}rg Kleeff and Helmut Friess},
  journal={Annals of Surgery},
  year={2008},
  volume={248},
  pages={52-60}
}
Summary Background Data:The role of a defunctioning stoma in patients undergoing low anterior resection for rectal cancer is still the subject of controversy. Recent studies suggest reduced morbidity after low anterior rectal resection with a defunctioning stoma. Methods:Retrospective and prospective studies published between 1966 and 2007 were systematically reviewed. Randomized controlled trials (RCTs) comparing anterior resections with or without defunctioning stoma were included in a meta… 
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463 Citations
Highly Influential Citations
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Background Citations
103
Methods Citations
10
Results Citations
12

463 Citations

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Citation Type

Meta-analysis of Temporary Ileostomy Versus Colostomy for Colorectal Anastomoses
TLDR
Each type of defunctioning stoma has its advantages and disadvantages, and there is not a strong evidence for the superiority of one temporary stoma over another for colorectal anastomoses.
Defunctioning ileostomy reduces leakage rate in rectal cancer surgery - systematic review and meta-analysis
TLDR
A defunctioning ileostomy may decrease the anastomotic leakage rate, additionally significantly reducing the risk of reoperations but it may also increase the overall complication rate.
Efficacy of transanal tube placement after anterior resection for rectal cancer: a systematic review and meta-analysis
TLDR
While studies are few and mostly observational, the data to date indicate that placement of a transanal tube decreases the rate of clinical anastomotic leakage and reoperation related to leakage.
Does a stoma reduce the risk of anastomotic leak and need for re-operation following low anterior resection for rectal cancer: systematic review and meta-analysis of randomized controlled trials.
TLDR
The present meta-analysis suggests a diverting or defunctioning stoma following LAR for rectal cancers can reduce anastomotic leak and reoperation rates, without increased risk of mortality or other complications.
Temporary ileostomy versus colostomy for colorectal anastomosis: evidence from 12 studies
TLDR
Temporary ileostomy has a minor impact on patients and is endorsed over colostomy after a low anterior resection for rectal cancer; the meta-analysis of the non-randomized studies showed a lower risk of stoma prolapse and wound infection after stoma closure in the temporary ILEostomy group.
The influence of diverting loop ileostomy vs. colostomy on postoperative morbidity in restorative anterior resection for rectal cancer: a systematic review and meta-analysis
TLDR
This meta-analysis found no difference between LI and LC in overall morbidity after stoma creation and closure, andMorbidity rates following the creation of LI were significantly decreased at the cost of a risk for dehydration.
Delayed Colo-anal Anastomosis for Rectal Cancer: Pelvic Morbidity, Functional Results and Oncological Outcomes: A Systematic Review
TLDR
DCAA offers an alternative to primary straight colo-anal anastomosis for low rectal cancer, and no need for protective ileostomy, with good functional and oncological outcomes.
A meta-analysis of the role of diverting ileostomy after rectal cancer surgery
TLDR
A lower leak rate in the presence of diverting ileostomy is supported by relatively weak evidence, and high-quality RCTs are needed before routine ileOSTomy diversions can be recommended after rectal cancer surgery.
Efficacy of a transanal drainage tube versus diverting stoma in protecting colorectal anastomosis: a systematic review and meta-analysis
TLDR
It might be reasonable to employ a TDT in place of a DS to protect low colorectal and coloanal anastomosis, with consequent considerable advantages in terms of the short- and long-term post-operative outcomes.
An updated meta-analysis of transanal drainage tube for prevention of anastomotic leak in anterior resection for rectal cancer.
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TLDR
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