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Open AccessArticle
An Institutional Shift from Routine to Selective Diversion of Low Anastomosis in Robotic TME Surgery for Rectal Cancer Patients Using the KHANS Technique: A Single-Centre Cohort Study
by
Rauand Duhoky
Rauand Duhoky 1,2,
Guglielmo Niccolò Piozzi
Guglielmo Niccolò Piozzi 1,
Marieke L. W. Rutgers
Marieke L. W. Rutgers 1,
Ioannis Mykoniatis
Ioannis Mykoniatis 1,
Najaf Siddiqi
Najaf Siddiqi 1,
Syed Naqvi
Syed Naqvi 1 and
Jim S. Khan
Jim S. Khan 1,3,*
1
Department of Colorectal Surgery, Portsmouth Hospitals University NHS Trust, Queen Alexandra Hospital, Southwick Hill Road, Cosham, Portsmouth PO6 3LY, UK
2
School of Computing, Faculty of Technology, University of Portsmouth, Portsmouth PO1 2UP, UK
3
Faculty of Science and Health, University of Portsmouth, Portsmouth PO1 2UP, UK
*
Author to whom correspondence should be addressed.
J. Pers. Med. 2024, 14(7), 725; https://doi.org/10.3390/jpm14070725 (registering DOI)
Submission received: 29 May 2024
/
Revised: 24 June 2024
/
Accepted: 3 July 2024
/
Published: 4 July 2024
Abstract
(1) Background: In recent years, there has been a change in practice for diverting stomas in rectal cancer surgery, shifting from routine diverting stomas to a more selective approach. Studies suggest that the benefits of temporary ileostomies do not live up to their risks, such as high-output stomas, stoma dysfunction, and reoperation. (2) Methods: All rectal cancer patients treated with a robotic resection in a single tertiary colorectal centre in the UK from 2013 to 2021 were analysed. In 2015, our unit made a shift to a more selective approach to temporary diverting ileostomies. The cohort was divided into a routine diversion group treated before 2015 and a selective diversion group treated after 2015. Both groups were analysed and compared for short-term outcomes and morbidities. (3) Results: In group A, 63/70 patients (90%) had a diverting stoma compared to 98/135 patients (72.6%) in group B (p = 0.004). There were no significant differences between the groups in anastomotic leakages (11.8% vs. 17.8%, p = 0.312) or other complications (p = 0.117). There were also no significant differences in readmission (3.8% vs. 2.6%, p = 0.312) or reoperation (3.8% vs. 2.6%, p = 1.000) after stoma closure. After 1 year, 71.6% and 71.9% (p = 1.000) of patients were stoma-free. One major reason for the delay in stoma reversal was the COVID-19 pandemic, which only occurred in group B (0% vs. 22%, p = 0.054). (4) Conclusions: A more selective approach to diverting stomas for robotic rectal cancer patients does not lead to more complications or leaks and can be considered in the treatment of rectal cancer tumours.
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MDPI and ACS Style
Duhoky, R.; Piozzi, G.N.; Rutgers, M.L.W.; Mykoniatis, I.; Siddiqi, N.; Naqvi, S.; Khan, J.S.
An Institutional Shift from Routine to Selective Diversion of Low Anastomosis in Robotic TME Surgery for Rectal Cancer Patients Using the KHANS Technique: A Single-Centre Cohort Study. J. Pers. Med. 2024, 14, 725.
https://doi.org/10.3390/jpm14070725
AMA Style
Duhoky R, Piozzi GN, Rutgers MLW, Mykoniatis I, Siddiqi N, Naqvi S, Khan JS.
An Institutional Shift from Routine to Selective Diversion of Low Anastomosis in Robotic TME Surgery for Rectal Cancer Patients Using the KHANS Technique: A Single-Centre Cohort Study. Journal of Personalized Medicine. 2024; 14(7):725.
https://doi.org/10.3390/jpm14070725
Chicago/Turabian Style
Duhoky, Rauand, Guglielmo Niccolò Piozzi, Marieke L. W. Rutgers, Ioannis Mykoniatis, Najaf Siddiqi, Syed Naqvi, and Jim S. Khan.
2024. "An Institutional Shift from Routine to Selective Diversion of Low Anastomosis in Robotic TME Surgery for Rectal Cancer Patients Using the KHANS Technique: A Single-Centre Cohort Study" Journal of Personalized Medicine 14, no. 7: 725.
https://doi.org/10.3390/jpm14070725
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