Our Summary
This research paper focuses on a common procedure performed in rectal cancer surgeries called “diverting ileostomy”. However, the procedure has a notable rate of complications. The study aimed to analyze how often and what types of complications occur in patients who underwent an ileostomy after rectal cancer surgery.
The study involved collecting data from patients at 45 colorectal surgery centers in Italy from February 15th to December 31st, 2022.
The findings showed that complications happened in about a third of patients after surgery, and still occurred in about 29.62% of patients in the long-term. The most common issues were dehydration, skin inflammation around the stoma (the opening where waste exits the body), separation of the skin and mucus lining around the stoma, and the stoma pulling inward.
Interestingly, the study also found that having a nurse specialized in stoma care significantly reduced the risk of these complications.
By the end of the follow-up period (average 9 months), about 84% of patients had their stoma closed up, with this process taking an average of 146 days. However, more than 15% of stomas were not closed by the end of follow-up.
In layman’s terms, this study highlights the significant risk of complications following a common rectal cancer surgery, but suggests that specialized nursing care can help to reduce these issues.
FAQs
- What is the rate of complications in patients who undergo a diverting ileostomy after rectal cancer surgery?
- What are the most common complications that occur after this procedure?
- Does having a nurse specialized in stoma care reduce the risk of complications after a diverting ileostomy?
Doctor’s Tip
One helpful tip a doctor might tell a patient about proctectomy is to make sure to follow the post-operative care instructions provided by your healthcare team. This can include proper wound care, taking prescribed medications, and attending follow-up appointments. Additionally, it’s important to communicate any concerns or changes in symptoms to your healthcare provider promptly. Finally, maintaining a healthy diet and staying active can help promote healing and overall recovery after surgery.
Suitable For
Patients who are typically recommended proctectomy include those with rectal cancer, inflammatory bowel disease (such as ulcerative colitis or Crohn’s disease), severe hemorrhoids, or other conditions affecting the rectum that have not responded to conservative treatments. Additionally, patients who have a high risk of developing rectal cancer, such as those with a family history of the disease or certain genetic conditions, may also be recommended for proctectomy. Other factors that may influence the recommendation for proctectomy include the size and location of the tumor, the patient’s overall health and ability to tolerate surgery, and their preferences for treatment options.
Timeline
Before the proctectomy, a patient will typically undergo various tests and consultations with their healthcare team to determine the best course of treatment. This may include imaging tests, blood work, and possibly chemotherapy or radiation therapy to shrink the tumor before surgery.
During the proctectomy procedure, the surgeon will remove part or all of the rectum and possibly nearby lymph nodes. In some cases, an ileostomy may be created to divert waste from the body while the remaining intestine heals. This involves creating a stoma on the abdomen through which waste is emptied into a pouch.
After the proctectomy, the patient will need to adjust to life with a stoma, including learning how to care for it, emptying the pouch, and managing any potential complications. Over time, the patient may undergo additional treatments, such as chemotherapy or radiation therapy, to prevent the cancer from returning.
If the patient had an ileostomy, they may eventually undergo a stoma reversal procedure to reconnect the intestine and close the stoma. This typically occurs several months after the initial surgery, once the intestine has had time to heal.
Overall, the timeline for a patient before and after a proctectomy can vary depending on the individual’s specific circumstances and treatment plan. It is important for patients to work closely with their healthcare team to ensure the best possible outcomes and quality of life following surgery.
What to Ask Your Doctor
Some questions a patient should ask their doctor about proctectomy include:
- What are the potential complications that can arise from a proctectomy procedure?
- How common are these complications in patients who undergo proctectomy?
- Are there any steps that can be taken to reduce the risk of complications following proctectomy?
- How long is the recovery process typically after a proctectomy?
- Will I need a temporary ileostomy or colostomy after the proctectomy procedure?
- How long will the ileostomy or colostomy need to be in place?
- What kind of specialized care will be provided for the stoma after the proctectomy?
- What are the signs of potential complications that I should be aware of post-surgery?
- How long does it typically take for the stoma to be closed up after the proctectomy?
- Are there any lifestyle changes or precautions I should take after the proctectomy procedure?
Reference
Authors: Ferrara F, Rizzo G, Bondurri A, Forni C, Anania G, Anastasi A, Baiocchi GL, Boccia L, Cassini D, Catarci M, Cestaro G, Cillara N, Cobellis F, De Luca R, De Nardi P, Deidda S, Delogu D, Fedi M, Giuffrida MC, Grossi U, Impellizzeri H, Langone A, Lauretta A, Lo Celso F, Maffioli A, Manigrasso M, Marafante C, Marano L, Marinello P, Massucco P, Merlini D, Morelli L, Mozzon M, Pafundi DP, Pata F, Pellino G, Peltrini R, Petrina A, Piazza D, Rabuini C, Resendiz A, Salmaso B, Santarelli M, Sena G, Siragusa L, Tamini N, Tondolo V, Tutino R, Vannelli A, Veltri M, Vincenti L, Parini D; MISSTO Snapshot Study Collaborative Group. Journal: Tech Coloproctol. 2024 Dec 11;29(1):16. doi: 10.1007/s10151-024-03047-6. PMID: 39661237