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Evidence summaries

Covering Stoma in Anterior Resection for Rectal Carcinoma

Covering stoma appears to prevent anastomotic leakage and urgent reoperations in patients receiving low anterior resection for rectal cancer. Level of evidence: "B"

A Cochrane review [Abstract] 1 included 6 studies with a total of 648 subjects. Studies comparing the use of temporary protective defunctioning stoma versus no stoma in patients that received low anterior resection for rectal cancer were included. Compared to controls, the use of covering stoma decreased anastomotic leakages (RR 0.33, 95% CI 0.21 to 0.53) and urgent reoperations (RR 0.23, 95% CI 0.12 to 0.42). There was no significant difference in terms of mortality (RR 0.58, 95% CI 0.14 to 2.33).

Comment: The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment and inadequate intention-to-treat adherence).

    References

    • Montedori A, Cirocchi R, Farinella E, Sciannameo F, Abraha I. Covering ileo- or colostomy in anterior resection for rectal carcinoma. Cochrane Database Syst Rev 2010 May 12;(5):CD006878. [PubMed]

Primary/Secondary Keywords