Combined stoma reversal and liver resection: a matched case–control study

• Published in: The American journal of surgery Vol. 210; no. 3; pp. 501 - 505
• Main Authors: Lupinacci, Renato M., Agostini, Julie, Chirica, Mircea, Balladur, Pierre, Chafaï, Najim, Parc, Yann, Tiret, Emmanuel, Paye, François
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2015; Elsevier Limited
• Subjects: Adult; Aged; Aged, 80 and over; Blood; Case-Control Studies; Chemotherapy; Colorectal cancer; Colorectal Neoplasms - pathology; Diverting ileostomy; Edema; Female; Hemorrhage; Hepatectomy; Hospitals; Humans; Ileostomy; Liver; Liver Neoplasms - secondary; Liver Neoplasms - surgery; Male; Metastasis; Middle Aged; Morbidity; Mortality; Ostomy; Patient Outcome Assessment; Retrospective Studies; Statistical analysis; Surgery; Metastasis; Diverting ileostomy; Morbidity; Colorectal cancer; Hepatectomy
• ISSN: 0002-9610; 1879-1883; 1879-1883
• DOI: 10.1016/j.amjsurg.2015.03.025

Stoma reversal can be performed during liver resection (LR) in patients with colorectal liver metastases (CRCLM) whose primary colorectal tumor has been previously resected with a diverting loop ileostomy. This combined procedure is reputed to be associated with an increased morbidity. This study investigates the impact of simultaneous loop ileostomy closure (LIC) on the postoperative outcome of LR for CRCLM. From November 1996 to April 2012, 408 patients who underwent LR for CRCLM were retrospectively studied from a prospective database. Patients who underwent simultaneous LR and LIC were matched for the type of the main liver procedure, the use of preoperative chemotherapy and the need for greater than or equal to 6 cycles of preoperative chemotherapy with LR only patients. Intraoperative and postoperative complications were recorded and compared. Twenty-four patients (6%) with simultaneous LR and LIC were matched with 72 patients with LR only. Both groups were comparable for patients’ demographics and intraoperative findings. Liver related (P = .957) and overall postoperative morbidity (P = .643) rates did not differ between groups. The combined procedure appeared to be safe when strict surgical technique is used. •A simultaneous loop ileostomy closure was performed in 6% of liver resections.•A strict operative protocol limits contamination of liver resection bed.•The simultaneous procedure did not increase the morbidity of liver resection.