TREATMENT OF COLORECTAL CANCER: PREEMPTIVE PROTECTIVE COLOSTOMY REDUCES SURGICAL MORTALITY AND REOPERATIONS

Summary Objectives: Rectosigmoidectomy and left colectomy are procedures widely used in the treatment of colorectal cancer. The manufacture of protective stoma is a controversial subject in the literature. We present a series of reference services in oncology in southern Brazil, comparatively analyzing the outcome of cases in relation to the presence or absence of protective colostomy. Methods: A retrospective descriptive comparative study. Patients submitted to rectosigmoidectomies/left collections in the period from September 2009 to December 2015 at Hospital Erasto Gaertner de Curitiba-PR were included. A comparative analysis was performed between the groups of patients according to whether or not protective colostomy was performed. Statistical analyses were performed with the support of the SPSS 23.0 and STATA 15 programs, p<0.05 being considered statistically significant. Results: We performed 355 rectosigmoidectomies/left collections for colorectal cancer, 136 (38.3%) without protective stoma and 219 (61.7%) with stoma. The anesthetic ASA risk was significantly higher in the group of patients with protective stoma. The production of the stoma did not add time to the surgical procedure. Severe complications (Clavien-Dindo 3-4-5) occurred in 84 (23.7%) of all patients, 61 (27.9%) with stoma and 23 (16.9%) without stomata (p=0.01). There was no significant difference in the rate of reoperation and surgical mortality between the groups. Laparoscopic surgery was associated with a smaller number of stomata. The length of hospital stay was no different between the groups, but ICU stay was significantly longer in the group of patients with protective stoma.

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
23 October 2019