La ileostomía de protección en el cáncer colorrectal

Abstract

Colorectal cancer is one of the most frequent tumors and one of the main causes of mortality worldwide. The most feared complication of rectal cancer surgery is anastomotic dehiscence, which presents a high morbidity and mortality. It not only represents a postoperative complication, but also negatively affects recurrence and long-term survival. Diverting stomas have been used to prevent complications secondary to dehiscence, causing an impact on the quality of life of patients, as well as morbidity and mortality associated with both the stoma itself and the transit reconstruction intervention. With this Doctoral Thesis carried out in a population with rectal cancer and subjected to an anterior resection with protective ileostomy, we evaluated: morbidity related to the stoma, morbidity of transit reconstruction and related factors (age, sex, ASA, treatment neoadjuvant and adjuvant, time to transit reconstruction). With the results obtained, and the scientific evidence, we can affirm that the protection ileostomy minimizes the consequences of dehiscence of the low colorectal or coloanal anastomosis and decreases the need for reoperation, although the morbidity is 30%, being serious in 2% of the cases. Transit reconstruction surgery should not be considered a minor intervention and has a high associated morbidity, although mortality is low