INFLUENCE OF DEFUNCTIONING COLOSTOMY AFTER LOW ANTERIOR RESECTION FOR RECTAL CANCER ON EARLY POSTOPERATIVE PERIOD

Abstract

The AIM of this study was to evaluate the influence of defunctioning colostomy after low anterior resection for cancer on early postoperative period and effectiveness of Fast Track protocol. MATERIALS. Retrospective analysis of medical records of 186 patients with rectal cancer who underwent anterior resection of the rectum in our department was done. All patients were allocated into 2 groups - conventional (had conventional perioperative care) and optimized (perioperative treatment according to Fast Track protocol). Both groups were subdivided into 3 subgroups (unprotected anastomosis, defunctioning colostomy and Hartmann procedure). The following data were analysed: average time of operation, operative bloodloss, volume of infusion and urination, time of mobilization removement of dranages and catheters, postoperative complications. RESULTS. Age, sex, comorbidities had no effect on decision about a preventive colostomy. The main reason for preventive colostomy was a middle-rectum location of a tumor. Preventive colostomy didn’t affect the course of early postoperative period in groups. Defunctioning colostomy effectively prevent catastrophic consequences of anastomotic leakage and didn’t compromise Fast Track protocol. CONCLUSION. Defunctioning colostomy did not reduce postoperative anastomotic leak rate, but mitigate consequences of an anastomotic leakage. Defunctioning colostomy did not affect the course of early postoperative period and Fast Track protocol.