{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T09:23:49Z","timestamp":1787217829767,"version":"build-2736575974"},"reference-count":31,"publisher":"Pensoft Publishers","issue":"4","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FM"],"abstract":"<jats:p>\n                    <jats:bold>Abstract<\/jats:bold>\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Introduction<\/jats:bold>\n                    : Postoperative anastomotic leakage is a serious complication in rectal surgery that affects quality of life, increases morbidity and mortality rates, and worsens oncologic outcomes. One of the methods that can minimize septic complications is a diverting ostomy. Although intended as temporary, approximately 20% of diverting stomas become permanent or are converted to end colostomies. Factors significantly increasing the risk of permanent stomas include advanced age, local recurrence, stoma-related complications, and impaired anal sphincter function caused by denervation during surgery or due to neo-adjuvant or adjuvant radiotherapy.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Aim<\/jats:bold>\n                    : This study aimed to identify the risk factors that increase the possibility of temporary stoma becoming permanent after low anterior resection.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Materials and methods<\/jats:bold>\n                    : For the described period, we reviewed a total of 418 histologically confirmed rectal cancer patients who underwent low anterior resection with temporary diverting ileostomy.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results<\/jats:bold>\n                    : Our study included 348 patients, of whom 324 (93.1%) had their stomas reversed. After a median follow-up of 50.4 months (range 6-106 months), 324 (93.1%) patients had temporary stomas and 24 (6.9%) had permanent ones. Of the 24 permanent stoma patients, there were 12 ileostomies (50.0%), 6 colostomies (25.0%), six patients with abdominoperineal resections (25.0%) due to total dehiscence of the anastomosis.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion<\/jats:bold>\n                    : Neo-adjuvant or adjuvant chemo and\/or radiation therapy, local recurrence, and anastomotic leakage could be important risk factors for the stoma\u2019s nonclosure or re-creation after primary closure in low rectal cancer patients. Surgeons should be more alert in the stoma closure of these risk patients.\n                  <\/jats:p>","DOI":"10.3897\/folmed.68.e167932","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T08:26:11Z","timestamp":1787214371000},"source":"Crossref","is-referenced-by-count":0,"title":["Risk factors for permanent stoma after low anterior resection"],"prefix":"10.3897","volume":"68","author":[{"given":"Gancho","family":"Kostov","sequence":"first","affiliation":[{"name":"Medical Simulation and Training Center, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mladen","family":"Doykov","sequence":"additional","affiliation":[{"name":"Kaspela University Hospital, Plovdiv, Bulgaria"},{"name":"Department of Urology and General Medicine, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossen","family":"Dimov","sequence":"additional","affiliation":[{"name":"Medical Simulation and Training Center, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria"},{"name":"Department of Special Surgery, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bozhidar","family":"Hristov","sequence":"additional","affiliation":[{"name":"Second Department of Internal Diseases, Section of Gastroenterology, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Doykov","sequence":"additional","affiliation":[{"name":"Second Department of Internal Diseases, Section of Gastroenterology, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katya","family":"Doykova","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lyubomir","family":"Chervenkov","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lyuboslav","family":"Dimov","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgi","family":"Amaliev","sequence":"additional","affiliation":[{"name":"Medical Simulation and Training Center, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentin","family":"Ivanov","sequence":"additional","affiliation":[{"name":"Medical Simulation and Training Center, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2258","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"key":"167932_B1","doi-asserted-by":"crossref","unstructured":"Bordeianeou L, Maguire LH, Alavi K, et al. Sphincter-sparing surgery in patients with low-lying rectal cancer: techniques, oncologic outcomes, and functional results. J Gastrointest Surg 2014;18:1358\u201372.","DOI":"10.1007\/s11605-014-2528-y"},{"key":"167932_B2","doi-asserted-by":"crossref","unstructured":"Rahbari NN, Weitz J, Hohenberger W, et al. Definition and grading of anastomotic leakage following anterior resection of the rectum: a proposal by the International Study Group of Rectal Cancer. Surgery 2010;147:339\u201351.","DOI":"10.1016\/j.surg.2009.10.012"},{"key":"167932_B3"},{"key":"167932_B4"},{"key":"167932_B5","doi-asserted-by":"crossref","unstructured":"Ihn\u00e1t P, Gu\u0148kov\u00e1 P, Peteja M, et all. Diverting ileostomy in laparoscopic rectal cancer surgery: the high price of protection. Surg Endosc 2016;30(11):4809\u201316.","DOI":"10.1007\/s00464-016-4811-3"},{"key":"167932_B6"},{"key":"167932_B7","doi-asserted-by":"crossref","unstructured":"Gadan S, Lindgren R, Floodeen H, et all. 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Timing of neonatal stoma closure: a survey of health professional perspectives and current practice. 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