[Stoma creation during low anterior resection: the cons]. / Stoma bei tiefer anteriorer Resektion: Kontra.
Chirurg
; 81(11): 968, 970-73, 2010 Nov.
Article
in De
| MEDLINE
| ID: mdl-21061113
ABSTRACT
Creation of a protective stoma is nowadays considered the standard of care in patients undergoing low rectal resection to protect these patients from the potentially hazardous consequences of an anastomotic leak. This appears reasonable in patients with acknowledged risk factors such as male gender, low anastomosis, preoperative radiochemotherapy, intraoperative complications, or steroid treatment to ensure patients' safety. However, from our view, it is debatable, if patients without these risk factors can undergo low rectal resection without a stoma. This approach can prevent patients form potential risks of stoma creation as well as closure and the associated readmission to the hospital. Based on reliable patient selection, avoiding a protective stoma during low rectal resection can increase patients' satisfaction and decrease primary and secondary medical costs. However, this approach is hampered by the lack of evidence for patient selection, leading to legal concerns that justify this approach only in highly motivated patients after detailed counseling of the individual patient.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Postoperative Complications
/
Rectum
/
Colostomy
Type of study:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspects:
Patient_preference
Limits:
Female
/
Humans
/
Male
Language:
De
Journal:
Chirurg
Year:
2010
Document type:
Article