Diverting Ileostomy in Rectal Cancer: Associated Morbidity and Delay in Reconstruction Times

Introduction: Rectal cancer treatment is being developed in many different ways, and the surgical one is probably breaking new ground. This is why we talk about sphincter-sparing surgery and the subsequent suggestive rise of diverting ileostomies. However, despite this fact, this approach has a considerable weakness which is usually underestimated.

Besides, reconstruction standards are not completely clear, and some published studies show evidence of increased complications and worse functional repercussions due to delayed times.

Objective: Not only discern the most real actuality of patients with ileostomies and define in a clear way the different complexities but also closing times and the certain analysis of all those circumstances it is influenced by.

Methods: Retrospective cohort study included patients operated on for rectal adenocarcinoma with diverting ileostomy between 2015 and 2019.

Results: There have been a total of 144 complications distributed in 106 of the 174 patients (61%), causing: 43 urgency admissions, 16 hospital admissions, 2 ICU admissions, and three surgical interventions prior to stomal reconstruction.

The median time up to stoma closure has been 10.2 months.

On the whole, neoadjuvant treatment, complications in the first surgery, adjuvant treatment, and ASA III–IV are the most important points associated with increased reconstruction time.

Moreover, 13.8% of registered patients have not been reconstructed by reason of death, progression, or anastomosis narrowing.

Conclusions: Diverting ileostomy presents considerable aggravations associated, and it is our commitment to take them into account every moment we indicate it.

As a result of clinical repercussions and health care costs associated with reconstruction of intestinal transit should be promoted as soon as possible.