{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T13:24:54Z","timestamp":1792070694171,"version":"4.4.0"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2009,4,8]],"date-time":"2009-04-08T00:00:00Z","timestamp":1239148800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,4,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A defunctioning stoma is frequently created to minimize the impact of any subsequent anastomotic leak after a low rectal anastomosis. This review evaluates the need for routine stoma formation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A meta-analysis was performed of randomized controlled trials (RCTs) and non-randomized studies with an interventional group evaluating the need for a defunctioning stoma after low anterior resection for rectal cancer. Primary outcomes analysed included clinical anastomotic leak rate, reoperation rate and mortality related to leak.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Four RCTs and 21 non-randomized studies, with 11 429 patients in total, were analysed. Meta-analysis of the RCTs showed a lower clinical anastomotic leak rate (risk ratio (RR) 0\u00b739 (95 per cent c.i. 0\u00b723 to 0\u00b766); P &amp;lt; 0\u00b7001) and a lower reoperation rate (RR 0\u00b729 (0\u00b716 to 0\u00b753); P &amp;lt; 0\u00b7001) in the stoma group. Meta-analysis of the non-randomized studies showed a lower clinical anastomotic leak rate (RR 0\u00b774 (0\u00b767 to 0\u00b783); P &amp;lt; 0\u00b7001), lower reoperation rate (RR 0\u00b728 (0\u00b723 to 0\u00b735); P &amp;lt; 0\u00b7001) and lower mortality rate (RR 0\u00b742 (0\u00b728 to 0\u00b761); P &amp;lt; 0\u00b7001) in the stoma group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A defunctioning stoma decreases clinical anastomotic leak rate and reoperation rate. It is recommended after low anterior resection for rectal cancer.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bjs.6594","type":"journal-article","created":{"date-parts":[[2009,4,8]],"date-time":"2009-04-08T14:43:38Z","timestamp":1239201818000},"page":"462-472","source":"Crossref","is-referenced-by-count":410,"title":["Meta-analysis of defunctioning stomas in low anterior resection for rectal cancer"],"prefix":"10.1093","volume":"96","author":[{"given":"W S","family":"Tan","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery, Singapore General Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C L","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Singapore General Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Shi","sequence":"additional","affiliation":[{"name":"Clinical Trials and Epidemiological Unit, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K W","family":"Eu","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Singapore General Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2009,4,8]]},"reference":[{"key":"2021070906264822900_bib1","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1111\/j.1463-1318.2004.00657.x","article-title":"Risk factors for anastomotic leakage after anterior resection of the rectum","volume":"6","author":"Matthiessen","year":"2004","journal-title":"Colorectal Dis"},{"key":"2021070906264822900_bib2","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1111\/j.1445-2197.2006.03780.x","article-title":"Anastomotic leakage after lower gastrointestinal anastomosis: men are at a higher risk","volume":"76","author":"Lipska","year":"2006","journal-title":"ANZ J 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