Risk Factors For Failure Of Stoma Reversal In Rectal Cancer

Objective:The aim of this study was to evaluate the risk factors causing failure of stoma reversal after low anterior resection with temporary ileostomy in rectal cancer patients.Methods:We retrospectively analyzed the clinical data of 1197 patients with rectal cancer admitted by Sir Runrun Shaw Hospital of Zhejiang University between November 2010 and April 2016.206 patients received low anterior resection and ileostomy.These patients were further divided into two groups:the reversal group and nonreversal group.The nonreversal stoma is defined as stoma not being reversed in 12 months or being recreated in 6 months after reversal.Then risk factors associated with stoma nonreversal were evaluated.Results:Of the 206 patients with ileostomy,179(86.9%)received stoma reversal and 27(13.1%)failed to closure of stoma.The median interval to reverse stoma was 5 months(mean ± standard deviation:5.65±2.54 months).Univariate analysis showed that the risk factors associated with nonreversal stoma were including systematic metastases(p=0.001),stage Ⅳ(p=0.018)and anastomotic related complications(p=0.000).Multivariate analysis showed that the independent risk factor for nonreversal stoma was anastomotic related complications(OR,21.963;95%CI,7.464-64.432;p = 0.000).Conclusion:Anastomotic related complications would increase the risk of non-reversal ileostomy in patients with rectal cancer,which should be informed to petients before operation.