{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T19:35:51Z","timestamp":1785008151449,"version":"3.55.0"},"reference-count":21,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,3,18]],"date-time":"2021-03-18T00:00:00Z","timestamp":1616025600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>This study aimed to investigate the use of defunctioning stomas after rectal cancer surgery in Australia and New Zealand, as current practice is unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From the Binational Colorectal Cancer Audit database, data on rectal cancer patients who underwent a resection between 2007 and 2019 with the formation of an anastomosis were extracted and analysed. The primary outcome was the rate of defunctioning stoma formation. Secondary outcomes were anastomotic leakage (AL) rates and other postoperative complications, length of hospital stay (LOS), readmissions and 30\u2010day mortality rates between stoma and no\u2010stoma groups. Propensity score matching was performed to correct for differences in baseline characteristics between stoma and no\u2010stoma groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 2581 (89%) received a defunctioning stoma and 319 (11%) did not. There were more male patients in the stoma group (65.5% vs. 57.7% for the no\u2010stoma group; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.006). The median age was 64\u00a0years in both groups. The stoma group underwent more ultra\u2010low anterior resections (79.9% vs. 30.1%; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001), included more American Joint Committee on Cancer Stage III patients (53.7% vs. 29.2%; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001) and received more neoadjuvant therapy (66.9% vs. 16.3%; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001). The AL rate was similar in both groups (5.1% vs. 6.0%; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.52). LOS was longer in the stoma group (8 vs. 6\u00a0days; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001) with higher 30\u2010day readmission rates (14.9% vs. 8.3%; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.003). After propensity score matching (<jats:italic>n<\/jats:italic>\u00a0=\u00a0208 in both groups), AL rates remained similar (2.9% for stoma vs. 5.8% for no\u2010stoma group; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.15), but stoma patients required less reoperations (0% vs. 8%; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.016). The stoma group had higher postoperative ileus rates and an increased LOS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In Australia and New Zealand, most patients who underwent rectal cancer resections with the formation of an anastomosis received a defunctioning stoma. A defunctioning stoma does not prevent AL from occurring but is mostly associated with a lower reoperation rate. Patients with a defunctioning stoma experienced a higher postoperative ileus rate and had an increased LOS.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.15607","type":"journal-article","created":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T09:41:57Z","timestamp":1614678117000},"page":"1421-1433","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Current practice in Australia and New Zealand for defunctioning ileostomy after rectal cancer surgery with anastomosis: Analysis of the Binational Colorectal Cancer Audit"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8815-2767","authenticated-orcid":false,"given":"Vera E. M.","family":"Grupa","sequence":"first","affiliation":[{"name":"Colorectal Unit Department of Surgery Royal Adelaide Hospital Adelaide South Australia Australia"},{"name":"Faculty of Medical Sciences Leiden University Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidde M.","family":"Kroon","sequence":"additional","affiliation":[{"name":"Colorectal Unit Department of Surgery Royal Adelaide Hospital Adelaide South Australia Australia"},{"name":"Faculty of Health and Medical Sciences School of Medicine University of Adelaide Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Izel","family":"Ozmen","sequence":"additional","affiliation":[{"name":"Colorectal Unit Department of Surgery Royal Adelaide Hospital Adelaide South Australia Australia"},{"name":"Faculty of Medical Sciences Leiden University Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergei","family":"Bedrikovetski","sequence":"additional","affiliation":[{"name":"Colorectal Unit Department of Surgery Royal Adelaide Hospital Adelaide South Australia Australia"},{"name":"Faculty of Health and Medical Sciences School of Medicine University of Adelaide Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9775-3599","authenticated-orcid":false,"given":"Nagendra N.","family":"Dudi\u2010Venkata","sequence":"additional","affiliation":[{"name":"Colorectal Unit Department of Surgery Royal Adelaide Hospital Adelaide South Australia Australia"},{"name":"Faculty of Health and Medical Sciences School of Medicine University of Adelaide Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald A.","family":"Hunter","sequence":"additional","affiliation":[{"name":"Colorectal Unit Department of Surgery Royal Adelaide Hospital Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4918-8871","authenticated-orcid":false,"given":"Tarik","family":"Sammour","sequence":"additional","affiliation":[{"name":"Colorectal Unit Department of Surgery Royal Adelaide Hospital Adelaide South Australia Australia"},{"name":"Faculty of Health and Medical Sciences School of Medicine University of Adelaide Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,18]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.30875\/9f925144-en"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2018.07.005"},{"key":"e_1_2_12_4_1","unstructured":"Bowel cancer (Colorectal cancer) in Australia statistics | Bowel cancer;2019.https:\/\/bowel\u2010cancer.canceraustralia.gov.au\/statistics\u2010Bowel\u2010cancer.canceraustralia.gov.au. 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