Defunctioning stoma in low anterior resection with colonic pouch for XXXX : a comparison between two hospitals with a different policy.

@entity1 @entity834 @entity5 @entity189 @entity530 @entity694
PURPOSE: The aim of this study was to compare surgical outcome, after low anterior resection for @entity5 with @entity694 , at two departments with a different policy regarding the use of a routine diverting stoma. METHODS: A total of 161 consecutive @entity1 with invasive @entity189 operated on between 1990 and 1997 with a total mesorectal excision and a @entity694 were included in the study. Eighty @entity1 were operated on in a surgical unit using routine defunctioning stomas (96 percent), whereas 81 were operated on in a department in which diversion was rarely used (5 percent). Recorded data with respect to surgical outcome were analyzed and compared. RESULTS: There was no difference between the two centers in postoperative mortality in connection with the primary resection and subsequent stoma reversal (3.7 vs. 3.8 percent). No significant difference could be found in the number of @entity1 with @entity530 ( @entity834 ; 9 vs.12 percent). Surgical outcome in @entity1 with @entity530 was also similar. The frequency of reoperations associated with the anterior resection and subsequent stoma reversal was identical (14 percent). The total hospital stay (primary operation and stoma reversal) was significantly longer with than without a routine stoma (17 (range, 2-59) vs. 12 (range, 5-55) days, respectively; P < 0.001). CONCLUSION: This study suggests that the routine use of diversion does not protect the @entity1 from anastomotic complications or @entity530 and its use requires a second admission for closure.
