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Long distance to hospital is not a risk factor for non-reversal of a defunctioning stoma
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences. (Clister)ORCID iD: 0000-0001-5076-7400
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences. (Clister)
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences. (Clister)
2019 (English)In: International Journal of Colorectal Disease, ISSN 0179-1958, E-ISSN 1432-1262, Vol. 34, no 6, p. 993-1000Article in journal (Refereed) Published
Abstract [en]

PURPOSE: To see if road distance to hospital influences stoma reversal rate, time from index operation to stoma reversal, and occurrence of permanent stoma.

METHODS: Data from all diagnosed cases of rectal cancer from three counties in northern Sweden were extracted from the Swedish Rectal Cancer Registry. The three counties are sparsely populated, with a population density roughly one fifth the average density in Sweden. Distances to nearest, operating, and largest hospital were obtained using Google Maps™. Matched data on socioeconomic variables were retrieved from Statistics Sweden.

RESULTS: In univariate logistic regression analysis, patients living closer to the operating hospital had a higher likelihood of non-reversal than those living farther away (OR 0.3; 95% CI 0.12-0.76). However, no difference was seen in the multivariate analysis. Of the 717 cases included, 54% received a permanent stoma and 38% a defunctioning stoma at index surgery. The reversal rate of a defunctioning stoma was 83%. At follow-up, 61% still had a stoma, 89% of these were permanent, and 11% non-reversed defunctioning stomas. Median time to stoma reversal was 287 days (82-1557 days). Of all 227 stoma reversals, 77% were done more than 6 months after index surgery.

CONCLUSIONS: Longer distance to hospital is not a risk factor for non-reversal of a defunctioning stoma. Only 23% had their defunctioning stoma reversed within 6 months after index surgery. Future studies aiming to determine reversal rate need to extend their follow-up time in order to receive accurate results.

Place, publisher, year, edition, pages
Springer, 2019. Vol. 34, no 6, p. 993-1000
Keywords [en]
Defunctioning stoma, Distance, Permanent stoma, Rectal cancer, Rural, Stoma reversal
National Category
Surgery
Identifiers
URN: urn:nbn:se:umu:diva-156475DOI: 10.1007/s00384-019-03258-6PubMedID: 30747282OAI: oai:DiVA.org:umu-156475DiVA, id: diva2:1289410
Funder
Västerbotten County Council, VLL-675981Available from: 2019-02-18 Created: 2019-02-18 Last updated: 2019-06-11Bibliographically approved

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Näverlo, SimonStrigård, KarinGunnarsson, Ulf
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