Published online Aug 27, 2022. doi: 10.4240/wjgs.v14.i8.765
Peer-review started: March 4, 2022
First decision: June 12, 2022
Revised: June 21, 2022
Accepted: July 20, 2022
Article in press: July 20, 2022
Published online: August 27, 2022
Approximately 20 percent of patients with a tumour localized in the low rectum still encounter the possibility of requiring permanent stoma (PS), which can cause drastic changes in lifestyle and physical perceptions.
To determine the risk factors for PS and to develop a prediction model to predict the probability of PS in rectal cancer patients after sphincter-saving surgery.
A retrospective cohort of 421 rectal cancer patients who underwent radical surgery at Taipei Medical University Hospital between January 2012 and Dece
The PS rate after sphincter-saving surgery was 15.1% (59/391) in our study after a median follow-up of 47.3 mo (range 7–114 mo). Multivariate logistic regression analysis demonstrated that local recurrence, perirectal abscess, anastomosis site stenosis, perineural invasion, tumor size and operative time were independent risk factors for PS. These identified risk factors were incorporated into the nomogram, and the concordance index of this model was 0.903 (95%CI: 0.851-0.955). According to the calibration curves, the nomogram represents a perfect prediction model.
Several risk factors for PS after sphincter-saving surgery were identified. Our nomogram exhibited perfect predictive ability and will improve a physician’s ability to communicate the benefits and risks of various treatment options in shared decision making.
Core Tip: Approximately 20 percent of patients with a tumour localized in the low rectum still encounter the possibility of requiring permanent stoma (PS), which can cause drastic changes in lifestyle and physical perceptions. The study aimed to identify the risk factors for PS in rectal cancer patients after sphincter-saving surgery. Our results showed that the predictive models constructed by clinicopathological features exhibited perfect predictive ability and will allow physicians to inform patients about the possibility of PS prior to surgery.