{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T08:08:15Z","timestamp":1788854895990,"version":"build-2803163510"},"reference-count":14,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Gastroent Surgery"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Long\u2010term stoma\u2010free outcomes after diverting stoma closure in patients who underwent sphincter\u2010preserving rectal cancer surgery with double\u2010stapling technique (DST) reconstruction following radiation\u2010based neoadjuvant treatment remain unclear. We evaluated delayed re\u2010stoma\u2010free survival, causes of delayed re\u2010stoma creation, and final stoma status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included patients who underwent sphincter\u2010preserving rectal cancer surgery with double\u2010stapling technique reconstruction and diverting stoma creation following radiation\u2010based neoadjuvant treatment between 2011 and 2024. The primary outcome was delayed re\u2010stoma\u2010free survival after initially successful stoma closure. Delayed re\u2010stoma was defined as re\u2010stoma creation more than 30\u2009days after closure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 296 patients, 168 received radiotherapy without additional preoperative systemic chemotherapy (non\u2010TNT), and 128 received total neoadjuvant therapy (TNT). Stoma closure was achieved in 287 patients (97.0%). Five required re\u2010stoma creation within 30\u2009days, leaving 282 with initially successful closure. During a median post\u2010closure follow\u2010up of 63\u2009months, delayed re\u2010stoma creation occurred in 25 patients (8.9%): structural anastomotic complications in 14, functional disorders in seven, tumor recurrence in three, and dysmotility\u2010related megacolon in one. Estimated delayed re\u2010stoma\u2010free survival was 93.3% at 3\u2009years and 90.3% at 5\u2009years, with no significant difference between the non\u2010TNT and TNT groups (log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.176). At the last follow\u2010up, 258 patients (87.2%) were stoma\u2010free.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Approximately 90% of patients were stoma\u2010free at the final follow\u2010up. Delayed re\u2010stoma creation was most commonly attributable to structural anastomotic complications. Long\u2010term stoma\u2010free status should be considered a clinically meaningful endpoint beyond stoma closure alone.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ags3.70279","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T07:32:21Z","timestamp":1788852741000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010Term Stoma\u2010Free Outcomes After Diverting Stoma Closure Following Radiation\u2010Based Neoadjuvant Treatment for Rectal Cancer"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8999-1020","authenticated-orcid":false,"given":"Hidetaka","family":"Ichikawa","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery Cancer Institute Hospital, Japanese Foundation for Cancer Research  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7509-9365","authenticated-orcid":false,"given":"Shimpei","family":"Matsui","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Cancer Institute Hospital, Japanese Foundation for Cancer Research  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kentaro","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Cancer Institute Hospital, Japanese Foundation for Cancer Research  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuki","family":"Noguchi","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Cancer Institute Hospital, Japanese Foundation for Cancer Research  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Sakamoto","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Cancer Institute Hospital, Japanese Foundation for Cancer Research  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3553-3590","authenticated-orcid":false,"given":"Toshiki","family":"Mukai","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Cancer Institute Hospital, Japanese Foundation for Cancer Research  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiro","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Cancer Institute Hospital, Japanese Foundation for Cancer Research  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Akiyoshi","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Cancer Institute Hospital, Japanese Foundation for Cancer Research  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1097\/SLA.0b013e3180603024","article-title":"Defunctioning Stoma Reduces Symptomatic Anastomotic Leakage After Low Anterior Resection of the Rectum for Cancer: A Randomized Multicenter Trial","volume":"246","author":"Matthiessen P.","year":"2007","journal-title":"Annals of Surgery"},{"key":"e_1_2_13_3_1","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1007\/s00384-009-0660-z","article-title":"The Morbidity Surrounding Reversal of Defunctioning Ileostomies: A Systematic Review of 48 Studies Including 6107 Cases","volume":"24","author":"Chow A.","year":"2009","journal-title":"International Journal of Colorectal Disease"},{"key":"e_1_2_13_4_1","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/S1470-2045(07)70047-5","article-title":"A Multivariate Analysis of Limiting Factors for Stoma Reversal in Patients With Rectal Cancer Entered Into the Total Mesorectal Excision Trial: A Retrospective Study","volume":"8","author":"Dulk M.","year":"2007","journal-title":"Lancet Oncology"},{"key":"e_1_2_13_5_1","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1016\/S1470-2045(21)00079-6","article-title":"Neoadjuvant Chemotherapy With FOLFIRINOX and Preoperative Chemoradiotherapy for Patients With Locally Advanced Rectal Cancer (UNICANCER\u2010PRODIGE 23): A Multicentre, Randomised, Open\u2010Label, Phase 3 Trial","volume":"22","author":"Conroy T.","year":"2021","journal-title":"Lancet Oncology"},{"key":"e_1_2_13_6_1","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/S1470-2045(20)30555-6","article-title":"Short\u2010Course Radiotherapy Followed by Chemotherapy Before Total Mesorectal Excision Versus Preoperative Chemoradiotherapy, Total Mesorectal Excision, and Optional Adjuvant Chemotherapy in Locally Advanced Rectal Cancer (RAPIDO): A Randomised, Open\u2010Label, Phase 3 Trial","volume":"22","author":"Bahadoer R. 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