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Colorectal Cancer Surgical Treatments / Surgical Site Infection Prevention · Journal article
Annals of Gastroenterological Surgery · September 8, 2026
Encouraging direction, but not yet definitive.
In this retrospective cohort of 296 patients undergoing sphincter-preserving rectal cancer surgery with diverting stoma after radiation-based neoadjuvant therapy, 97% achieved stoma closure and 87.2% remained stoma-free at final follow-up. Delayed re-stoma creation occurred in 8.9% over a median 63-month follow-up, most often due to structural anastomotic complications, with no difference between TNT and non-TNT subgroups.
Retrospective cohort study. Patients with rectal cancer undergoing sphincter-preserving surgery with double-stapling technique reconstruction and diverting stoma after radiation-based neoadjuvant treatment, 2011–2024.. Intervention: Sphincter-preserving rectal cancer surgery with double-stapling technique reconstruction and diverting stoma following radiation-based neoadjuvant treatment (radiotherapy alone or total neoadjuvant therapy). Compared with: Non-TNT group (radiotherapy alone) versus TNT group (total neoadjuvant therapy). n = 296. Not stated.
Stoma closure achieved in 287 of 296 patients (97.0%) 282 patients with initially successful closure (5 required re-stoma within 30 days) Delayed re-stoma creation in 25 of 282 patients (8.9%) during median 63-month post-closure follow-up
Reasons for loss to follow-up not reported; actual final stoma-free rate may differ if patients with adverse outcomes were lost
These findings suggest that approximately 9 in 10 patients can maintain stoma-free status long-term after sphincter-preserving rectal cancer surgery with diverting stoma, supporting this approach as durable. Clinicians should counsel patients that structural anastomotic complications are the leading cause of delayed re-stoma creation and monitor accordingly.
A retrospective cohort study with adequate sample size and long follow-up (median 63 months) reporting a clinically meaningful primary endpoint (delayed re-stoma-free survival), but lacks a comparator group and prospective design; results support the durability of sphincter-preserving surgery but require confirmation in prospective studies.
As stated by the source record.
Quoted from the source exactly as published.
These findings suggest that approximately 9 in 10 patients can maintain stoma-free status long-term after sphincter-preserving rectal cancer surgery with diverting stoma, supporting this approach as durable. Clinicians should counsel patients that structural anastomotic complications are the leading cause of delayed re-stoma creation and monitor accordingly.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
ABSTRACT Aim Long‐term stoma‐free outcomes after diverting stoma closure in patients who underwent sphincter‐preserving rectal cancer surgery with double‐stapling technique (DST) reconstruction following radiation‐based neoadjuvant treatment remain unclear. We evaluated delayed re‐stoma‐free survival, causes of delayed re‐stoma creation, and final stoma status. Methods This retrospective cohort study included patients who underwent sphincter‐preserving rectal cancer surgery with double‐stapling technique reconstruction and diverting stoma creation following radiation‐based neoadjuvant treatment between 2011 and 2024. The primary outcome was delayed re‐stoma‐free survival after initially successful stoma closure. Delayed re‐stoma was defined as re‐stoma creation more than 30 days after closure. Results Among 296 patients, 168 received radiotherapy without additional preoperative systemic chemotherapy (non‐TNT), and 128 received total neoadjuvant therapy (TNT). Stoma closure was achieved in 287 patients (97.0%). Five required re‐stoma creation within 30 days, leaving 282 with initially successful closure. During a median post‐closure follow‐up of 63 months, delayed re‐stoma creation occurred in 25 patients (8.9%): structural anastomotic complications in 14, functional disorders in seven, tumor recurrence in three, and dysmotility‐related megacolon in one. Estimated delayed re‐stoma‐free survival was 93.3% at 3 years and 90.3% at 5 years, with no significant difference between the non‐TNT and TNT groups (log‐rank p = 0.176). At the last follow‐up, 258 patients (87.2%) were stoma‐free. Conclusion Approximately 90% of patients were stoma‐free at the final follow‐up. Delayed re‐stoma creation was most commonly attributable to structural anastomotic complications. Long‐term stoma‐free status should be considered a clinically meaningful endpoint beyond stoma closure alone.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.