Fate of temporary stomas created during anus-preserving surgery:Are anorectal functional examinations and defecography before stoma closure useful?

• Published in: Journal of Japanese Society of Stoma and Continence Rehabilitation Vol. 38; no. 2; pp. 39 - 49
• Main Authors: Homma, Yuko, Taguchi, Miyuki, Mimura, Toshiki, Horie, Hisanaga
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of Stoma and Continence Rehabilitation 2022; 日本ストーマ・排泄リハビリテーション学会
• Subjects: Anorectal physiology examinations; Defecography; Stoma closure; ストーマ閉鎖; 排便造影検査; 直腸肛門機能検査
• ISSN: 1882-0115; 2434-3056
• DOI: 10.32158/jsscr.38.2_39

Purpose: This study aimed to investigate the results of temporary stomas created during anus-preserving surgery and to evaluate the usefulness of anorectal physiology examinations and defecography (exams).Methods: The subjects were patients who underwent anus-preserving surgery with stomas between 2014 and 2019. The results of stoma closure and the usefulness of exams for decision-making were retrospectively investigated.Results: The subjects were 97 patients (median age 62 years, 72 males). The stoma was closed in 91 patients (94%). Exams were performed in 11 patients, showing reduced capacity of the neorectum in all. Of 6 patients whose stomas were not closed, 4 (67%) had no choice but to keep their stomas due to original disease aggravation, anastomotic stenosis, or anastomotic leakage, whereas 2 female (33%) patients opted not to have their stoma closed. Of the 2 patients, one whose exam results were good attributed the results to her decision not to close her stoma, whereas the other whose exam results were poor did not attribute the results to her decision.Conclusion: Anorectal physiology examinations and defecography could be useful in shared decision-making for stoma closure by giving patients and surgeons an opportunity to discuss low anterior resection syndrome, although stoma closure is not decided solely based on the exam results.