Long-term stoma-related reinterventions after anterior resection for rectal cancer with or without anastomosis: population data from the Dutch snapshot study

S. J. A. Hazen; I. Vogel; W. A. A. Borstlap; J. W. T. Dekker; J. B. Tuynman; P. J. Tanis; M. Kusters; the Dutch Snapshot Research Group

doi:10.1007/s10151-021-02543-3

Long-term stoma-related reinterventions after anterior resection for rectal cancer with or without anastomosis: population data from the Dutch snapshot study

S. J. A. Hazen, I. Vogel, W. A. A. Borstlap, J. W. T. Dekker, J. B. Tuynman, P. J. Tanis, M. Kusters^*, the Dutch Snapshot Research Group

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background: The aim of this study was to analyze the stoma-related reinterventions, complications and readmissions after an anterior resection for rectal cancer, based on a cross-sectional nationwide cohort study with 3-year follow-up. Methods: Rectal cancer patients who underwent a resection with either a functional anastomosis, a defunctioned anastomosis, or Hartmann’s procedure (HP) with an end colostomy in 2011 in 71 Dutch hospitals were included. The primary outcome was number of stoma-related reinterventions. Results: Of the 2095 patients with rectal cancer, 1400 patients received an anterior resection and were included in this study; 257 received an initially functional anastomosis, 741 a defunctioned anastomosis, and 402 patients a HP. Of the 1400 included patients, 62% were males, 38% were females and the mean age was 67 years (SD 11.1). Following a primary functional anastomosis, 48 (19%) patients received a secondary stoma. Stoma-related complications occurred in six (2%) patients, requiring reintervention in one (0.4%) case. In the defunctioned anastomosis group, stoma-related complications were present in 92 (12%) patients, and required reintervention in 23 (3%) patients, in 10 (1%) of these more than 1 year after initial resection. Stoma-related complications occurred in 92 (23%) patients after a HP, and required reintervention in 39 (10%) patients in 17 (4%) of cases more than 1 year after initial resection. The permanent stoma rate was 11% and 20%, in the functional anastomosis and the defuctioned anastomosis group, respectively. The end colostomy in the HP group was reversed in 4% of cases. Conclusions: Construction of a stoma after resection for rectal cancer with preservation of the sphincter is accompanied with long-term stoma-related morbidity. Stoma complications are more frequent after a HP. Even after 1 year, a significant number of reinterventions are required.

Original language	English
Journal	Techniques in Coloproctology
Early online date	26 Nov 2021
DOIs	https://doi.org/10.1007/s10151-021-02543-3
Publication status	E-pub ahead of print - 26 Nov 2021

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10.1007/s10151-021-02543-3

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Hazen, S. J. A., Vogel, I., Borstlap, W. A. A., Dekker, J. W. T., Tuynman, J. B., Tanis, P. J., Kusters, M., & the Dutch Snapshot Research Group (2021). Long-term stoma-related reinterventions after anterior resection for rectal cancer with or without anastomosis: population data from the Dutch snapshot study. Techniques in Coloproctology. https://doi.org/10.1007/s10151-021-02543-3

@article{52dd78e3f96c4a5aab6c0616fd885082,

title = "Long-term stoma-related reinterventions after anterior resection for rectal cancer with or without anastomosis: population data from the Dutch snapshot study",

abstract = "Background: The aim of this study was to analyze the stoma-related reinterventions, complications and readmissions after an anterior resection for rectal cancer, based on a cross-sectional nationwide cohort study with 3-year follow-up. Methods: Rectal cancer patients who underwent a resection with either a functional anastomosis, a defunctioned anastomosis, or Hartmann{\textquoteright}s procedure (HP) with an end colostomy in 2011 in 71 Dutch hospitals were included. The primary outcome was number of stoma-related reinterventions. Results: Of the 2095 patients with rectal cancer, 1400 patients received an anterior resection and were included in this study; 257 received an initially functional anastomosis, 741 a defunctioned anastomosis, and 402 patients a HP. Of the 1400 included patients, 62% were males, 38% were females and the mean age was 67 years (SD 11.1). Following a primary functional anastomosis, 48 (19%) patients received a secondary stoma. Stoma-related complications occurred in six (2%) patients, requiring reintervention in one (0.4%) case. In the defunctioned anastomosis group, stoma-related complications were present in 92 (12%) patients, and required reintervention in 23 (3%) patients, in 10 (1%) of these more than 1 year after initial resection. Stoma-related complications occurred in 92 (23%) patients after a HP, and required reintervention in 39 (10%) patients in 17 (4%) of cases more than 1 year after initial resection. The permanent stoma rate was 11% and 20%, in the functional anastomosis and the defuctioned anastomosis group, respectively. The end colostomy in the HP group was reversed in 4% of cases. Conclusions: Construction of a stoma after resection for rectal cancer with preservation of the sphincter is accompanied with long-term stoma-related morbidity. Stoma complications are more frequent after a HP. Even after 1 year, a significant number of reinterventions are required.",

keywords = "Anastomosis, Anterior resection, Hartmann{\textquoteright}s procedure, Permanent stoma, Rectal cancer",

author = "Hazen, {S. J. A.} and I. Vogel and Borstlap, {W. A. A.} and Dekker, {J. W. T.} and Tuynman, {J. B.} and Tanis, {P. J.} and M. Kusters and {the Dutch Snapshot Research Group} and Deijen, {C. L.} and {den Dulk}, M. and Bonjer, {H. J.} and {van de Velde}, {C. J.} and Aalbers, {A. G. J.} and Y. Acherman and Algie, {G. D.} and {von Geusau}, {B. Alting} and F. Amelung and Aukema, {T. S.} and Bakker, {I. S.} and Bartels, {S. A.} and S. Basha and Bastiaansen, {A. J. N. M.} and E. Belgers and W. Bleeker and J. Blok and Bosker, {R. J. I.} and Bosmans, {J. W.} and Boute, {M. C.} and Bouvy, {N. D.} and H. Bouwman and A. Brandt-Kerkhof and Brinkman, {D. J.} and S. Bruin and Bruns, {E. R. J.} and Burbach, {J. P. M.} and Burger, {J. W. A.} and Buskens, {C. J.} and S. Clermonts and Coene, {P. P. L. O.} and C. Compaan and Consten, {E. C. J.} and T. Darbyshire and {de Mik}, {S. M. L.} and {de Graaf}, {E. J. R.} and {de Groot}, I. and {Nederveen Cappel}, {R. J. L. de vos tot} and {de Wilt}, {J. H. W.} and {van der Wolde}, J. and Boer, {F. C. den} and A. Demirkiran and M. Derkx-Hendriksen and Dijkstra, {F. R.} and {van Duijvendijk}, P. and Dunker, {M. S.} and Eijsbouts, {Q. E.} and H. Fabry and F. Ferenschild and Foppen, {J. W.} and Furnee, {E. J. B.} and Gerhards, {M. F.} and P. Gerven and Gooszen, {J. A. H.} and Govaert, {J. A.} and {van Grevenstein}, {W. M. U.} and R. Haen and Harlaar, {J. J.} and E. Harst and K. Havenga and J. Heemskerk and Heeren, {J. F.} and B. Heijnen and P. Heres and C. Hoff and W. Hogendoorn and P. Hoogland and A. Huijbers and Gooszen, {J. A. H.} and P. Janssen and Jongen, {A. C.} and Jonker, {F. H.} and Karthaus, {E. G.} and A. Keijzer and Ketel, {J. M. A.} and J. Klaase and Kloppenberg, {F. W. H.} and Kool, {M. E.} and R. Kortekaas and Kruyt, {P. M.} and Kuiper, {J. T.} and B. Lamme and Lange, {J. F.} and T. Lettinga and Lips, {D. J.} and F. Logeman and {Lutke Holzik}, {M. F.} and E. Madsen and A. Mamound and Marres, {C. C.} and I. Masselink and M. Meerdink and Menon, {A. G.} and Mieog, {J. S.} and D. Mierlo and Musters, {G. D.} and Neijenhuis, {P. A.} and J. Nonner and M. Oostdijk and Oosterling, {S. J.} and Paul, {P. M. P.} and Peeters, {K. C. M. J. C.} and Pereboom, {I. T. A.} and F. Polat and P. Poortman and M. Raber and Reiber, {B. M. M.} and Renger, {R. J.} and {van Rossem}, {C. C.} and Rutten, {H. J.} and A. Rutten and R. Schaapman and M. Scheer and L. Schoonderwoerd and N. Schouten and Schreuder, {A. M.} and Schreurs, {W. H.} and Simkens, {G. A.} and Slooter, {G. D.} and Sluijmer, {H. C. E.} and N. Smakman and R. Smeenk and Snijders, {H. S.} and Sonneveld, {D. J. A.} and B. Spaansen and {Spillenaar Bilgen}, {E. J.} and E. Steller and Steup, {W. H.} and C. Steur and E. Stortelder and J. Straatman and Swank, {H. A.} and C. Sietses and {ten Berge}, {H. A.} and {ten hoeve}, {H. G.} and {ter Riele}, {W. W.} and Thorensen, {I. M.} and B. Tip-Pluijm and Toorenvliet, {B. R.} and L. Tseng and {van Bastelaar}, J. and {van beek}, {S. C.} and {van de Ven}, {A. W. H.} and {van de Weijer}, {M. A. J.} and {van den Berg}, C. and {van den Bosch}, I. and {van der Bilt}, {J. D. W.} and {van der Hagen}, {S. J.} and {van der hul}, R. and {van der Schelling}, G. and {van der Spek}, A. and {van der Wielen}, N. and {van duyn}, E. and {van Eekelen}, C. and {van Essen}, {J. A.} and {van Gangelt}, K. and {van Geloven}, {A. A. W.} and {van kessel}, C. and {van Loon}, {Y. T.} and {van Rijswijk}, A. and {van Rooijen}, {S. J.} and {van Sprundel}, T. and {van Steensel}, L. and {van Tets}, {W. F.} and {van Westreenen}, {H. L.} and S. Veltkamp and T. Verhaak and Verheijen, {P. M.} and L. Versluis-Ossenwaarde and S. Vijfhuize and Vles, {W. J.} and S. Voeten and Vogelaar, {F. J.} and Vrijland, {W. W.} and E. Westerduin and Westerterp, {M. E.} and M. Wetzel and K. Wevers and B. Wiering and Witjes, {A. C.} and Wouters, {M. W.} and Yauw, {S. T. K.} and Zeestraten, {E. C.} and Zimmerman, {D. D.} and T. Zwieten",

note = "Publisher Copyright: {\textcopyright} 2021, Springer Nature Switzerland AG.",

year = "2021",

month = nov,

day = "26",

doi = "10.1007/s10151-021-02543-3",

language = "English",

journal = "Techniques in Coloproctology",

issn = "1123-6337",

publisher = "Springer-Verlag Italia",

}

TY - JOUR

T1 - Long-term stoma-related reinterventions after anterior resection for rectal cancer with or without anastomosis

T2 - population data from the Dutch snapshot study

AU - Hazen, S. J. A.

AU - Vogel, I.

AU - Borstlap, W. A. A.

AU - Dekker, J. W. T.

AU - Tuynman, J. B.

AU - Tanis, P. J.

AU - Kusters, M.

AU - the Dutch Snapshot Research Group

AU - Deijen, C. L.

AU - den Dulk, M.

AU - Bonjer, H. J.

AU - van de Velde, C. J.

AU - Aalbers, A. G. J.

AU - Acherman, Y.

AU - Algie, G. D.

AU - von Geusau, B. Alting

AU - Amelung, F.

AU - Aukema, T. S.

AU - Bakker, I. S.

AU - Bartels, S. A.

AU - Basha, S.

AU - Bastiaansen, A. J. N. M.

AU - Belgers, E.

AU - Bleeker, W.

AU - Blok, J.

AU - Bosker, R. J. I.

AU - Bosmans, J. W.

AU - Boute, M. C.

AU - Bouvy, N. D.

AU - Bouwman, H.

AU - Brandt-Kerkhof, A.

AU - Brinkman, D. J.

AU - Bruin, S.

AU - Bruns, E. R. J.

AU - Burbach, J. P. M.

AU - Burger, J. W. A.

AU - Buskens, C. J.

AU - Clermonts, S.

AU - Coene, P. P. L. O.

AU - Compaan, C.

AU - Consten, E. C. J.

AU - Darbyshire, T.

AU - de Mik, S. M. L.

AU - de Graaf, E. J. R.

AU - de Groot, I.

AU - Nederveen Cappel, R. J. L. de vos tot

AU - de Wilt, J. H. W.

AU - van der Wolde, J.

AU - Boer, F. C. den

AU - Demirkiran, A.

AU - Derkx-Hendriksen, M.

AU - Dijkstra, F. R.

AU - van Duijvendijk, P.

AU - Dunker, M. S.

AU - Eijsbouts, Q. E.

AU - Fabry, H.

AU - Ferenschild, F.

AU - Foppen, J. W.

AU - Furnee, E. J. B.

AU - Gerhards, M. F.

AU - Gerven, P.

AU - Gooszen, J. A. H.

AU - Govaert, J. A.

AU - van Grevenstein, W. M. U.

AU - Haen, R.

AU - Harlaar, J. J.

AU - Harst, E.

AU - Havenga, K.

AU - Heemskerk, J.

AU - Heeren, J. F.

AU - Heijnen, B.

AU - Heres, P.

AU - Hoff, C.

AU - Hogendoorn, W.

AU - Hoogland, P.

AU - Huijbers, A.

AU - Gooszen, J. A. H.

AU - Janssen, P.

AU - Jongen, A. C.

AU - Jonker, F. H.

AU - Karthaus, E. G.

AU - Keijzer, A.

AU - Ketel, J. M. A.

AU - Klaase, J.

AU - Kloppenberg, F. W. H.

AU - Kool, M. E.

AU - Kortekaas, R.

AU - Kruyt, P. M.

AU - Kuiper, J. T.

AU - Lamme, B.

AU - Lange, J. F.

AU - Lettinga, T.

AU - Lips, D. J.

AU - Logeman, F.

AU - Lutke Holzik, M. F.

AU - Madsen, E.

AU - Mamound, A.

AU - Marres, C. C.

AU - Masselink, I.

AU - Meerdink, M.

AU - Menon, A. G.

AU - Mieog, J. S.

AU - Mierlo, D.

AU - Musters, G. D.

AU - Neijenhuis, P. A.

AU - Nonner, J.

AU - Oostdijk, M.

AU - Oosterling, S. J.

AU - Paul, P. M. P.

AU - Peeters, K. C. M. J. C.

AU - Pereboom, I. T. A.

AU - Polat, F.

AU - Poortman, P.

AU - Raber, M.

AU - Reiber, B. M. M.

AU - Renger, R. J.

AU - van Rossem, C. C.

AU - Rutten, H. J.

AU - Rutten, A.

AU - Schaapman, R.

AU - Scheer, M.

AU - Schoonderwoerd, L.

AU - Schouten, N.

AU - Schreuder, A. M.

AU - Schreurs, W. H.

AU - Simkens, G. A.

AU - Slooter, G. D.

AU - Sluijmer, H. C. E.

AU - Smakman, N.

AU - Smeenk, R.

AU - Snijders, H. S.

AU - Sonneveld, D. J. A.

AU - Spaansen, B.

AU - Spillenaar Bilgen, E. J.

AU - Steller, E.

AU - Steup, W. H.

AU - Steur, C.

AU - Stortelder, E.

AU - Straatman, J.

AU - Swank, H. A.

AU - Sietses, C.

AU - ten Berge, H. A.

AU - ten hoeve, H. G.

AU - ter Riele, W. W.

AU - Thorensen, I. M.

AU - Tip-Pluijm, B.

AU - Toorenvliet, B. R.

AU - Tseng, L.

AU - van Bastelaar, J.

AU - van beek, S. C.

AU - van de Ven, A. W. H.

AU - van de Weijer, M. A. J.

AU - van den Berg, C.

AU - van den Bosch, I.

AU - van der Bilt, J. D. W.

AU - van der Hagen, S. J.

AU - van der hul, R.

AU - van der Schelling, G.

AU - van der Spek, A.

AU - van der Wielen, N.

AU - van duyn, E.

AU - van Eekelen, C.

AU - van Essen, J. A.

AU - van Gangelt, K.

AU - van Geloven, A. A. W.

AU - van kessel, C.

AU - van Loon, Y. T.

AU - van Rijswijk, A.

AU - van Rooijen, S. J.

AU - van Sprundel, T.

AU - van Steensel, L.

AU - van Tets, W. F.

AU - van Westreenen, H. L.

AU - Veltkamp, S.

AU - Verhaak, T.

AU - Verheijen, P. M.

AU - Versluis-Ossenwaarde, L.

AU - Vijfhuize, S.

AU - Vles, W. J.

AU - Voeten, S.

AU - Vogelaar, F. J.

AU - Vrijland, W. W.

AU - Westerduin, E.

AU - Westerterp, M. E.

AU - Wetzel, M.

AU - Wevers, K.

AU - Wiering, B.

AU - Witjes, A. C.

AU - Wouters, M. W.

AU - Yauw, S. T. K.

AU - Zeestraten, E. C.

AU - Zimmerman, D. D.

AU - Zwieten, T.

PY - 2021/11/26

Y1 - 2021/11/26

N2 - Background: The aim of this study was to analyze the stoma-related reinterventions, complications and readmissions after an anterior resection for rectal cancer, based on a cross-sectional nationwide cohort study with 3-year follow-up. Methods: Rectal cancer patients who underwent a resection with either a functional anastomosis, a defunctioned anastomosis, or Hartmann’s procedure (HP) with an end colostomy in 2011 in 71 Dutch hospitals were included. The primary outcome was number of stoma-related reinterventions. Results: Of the 2095 patients with rectal cancer, 1400 patients received an anterior resection and were included in this study; 257 received an initially functional anastomosis, 741 a defunctioned anastomosis, and 402 patients a HP. Of the 1400 included patients, 62% were males, 38% were females and the mean age was 67 years (SD 11.1). Following a primary functional anastomosis, 48 (19%) patients received a secondary stoma. Stoma-related complications occurred in six (2%) patients, requiring reintervention in one (0.4%) case. In the defunctioned anastomosis group, stoma-related complications were present in 92 (12%) patients, and required reintervention in 23 (3%) patients, in 10 (1%) of these more than 1 year after initial resection. Stoma-related complications occurred in 92 (23%) patients after a HP, and required reintervention in 39 (10%) patients in 17 (4%) of cases more than 1 year after initial resection. The permanent stoma rate was 11% and 20%, in the functional anastomosis and the defuctioned anastomosis group, respectively. The end colostomy in the HP group was reversed in 4% of cases. Conclusions: Construction of a stoma after resection for rectal cancer with preservation of the sphincter is accompanied with long-term stoma-related morbidity. Stoma complications are more frequent after a HP. Even after 1 year, a significant number of reinterventions are required.

AB - Background: The aim of this study was to analyze the stoma-related reinterventions, complications and readmissions after an anterior resection for rectal cancer, based on a cross-sectional nationwide cohort study with 3-year follow-up. Methods: Rectal cancer patients who underwent a resection with either a functional anastomosis, a defunctioned anastomosis, or Hartmann’s procedure (HP) with an end colostomy in 2011 in 71 Dutch hospitals were included. The primary outcome was number of stoma-related reinterventions. Results: Of the 2095 patients with rectal cancer, 1400 patients received an anterior resection and were included in this study; 257 received an initially functional anastomosis, 741 a defunctioned anastomosis, and 402 patients a HP. Of the 1400 included patients, 62% were males, 38% were females and the mean age was 67 years (SD 11.1). Following a primary functional anastomosis, 48 (19%) patients received a secondary stoma. Stoma-related complications occurred in six (2%) patients, requiring reintervention in one (0.4%) case. In the defunctioned anastomosis group, stoma-related complications were present in 92 (12%) patients, and required reintervention in 23 (3%) patients, in 10 (1%) of these more than 1 year after initial resection. Stoma-related complications occurred in 92 (23%) patients after a HP, and required reintervention in 39 (10%) patients in 17 (4%) of cases more than 1 year after initial resection. The permanent stoma rate was 11% and 20%, in the functional anastomosis and the defuctioned anastomosis group, respectively. The end colostomy in the HP group was reversed in 4% of cases. Conclusions: Construction of a stoma after resection for rectal cancer with preservation of the sphincter is accompanied with long-term stoma-related morbidity. Stoma complications are more frequent after a HP. Even after 1 year, a significant number of reinterventions are required.

KW - Anastomosis

KW - Anterior resection

KW - Hartmann’s procedure

KW - Permanent stoma

KW - Rectal cancer

UR - http://www.scopus.com/inward/record.url?scp=85120041732&partnerID=8YFLogxK

U2 - 10.1007/s10151-021-02543-3

DO - 10.1007/s10151-021-02543-3

M3 - Article

C2 - 34837140

SN - 1123-6337

JO - Techniques in Coloproctology

JF - Techniques in Coloproctology

ER -

Long-term stoma-related reinterventions after anterior resection for rectal cancer with or without anastomosis: population data from the Dutch snapshot study

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