TEMPORARY FECAL DIVERSION STUDENTS’ SESSION, 10TH ANNUAL ESCP MEETING, DUBLIN ANDERS MARK CHRISTENSEN ON BEHALF OF GROUP 2

TEMPORARY FECAL DIVERSION IN COLORECTAL RESECTIONS CURRENT EVIDENCE: IN LOW RECTAL CANCER (4 RCT’S, 358 PATIENTS): [ANN SURG 2008;248(1):52-60] FEWER ANASTOMOTIC LEAKS (OR 0.32 (0.17; 0.59)) FEWER REOPERATIONS (OR 0.27 (0.14; 0.51)) NO EFFECT ON MORTALITY NO DATA ON LONG-TERM FUNCTIONAL OUTCOME (E.G. LOW ANTERIOR RESECTION SYNDROME LARS)

TEMPORARY FECAL DIVERSION IN COLORECTAL RESECTIONS CURRENT EVIDENCE: IN RESTORATIVE PROCTOCOLECTOMY 17 STUDIES (1 RCT), 1486 PATIENTS): [ARCH SURG 2008;143(4): ] FEWER ANASTOMOTIC LEAKS (OR 0.44 (0.26; 0.75)) FEWER POUCH FAILURES (OR 0.3 (0.12; 0.74)) FEWER STRICTURES (OR 0.31 (0.1; 0.98)) NO DIFFERENCE IN FUNCTIONAL OUTCOME

TEMPORARY FECAL DIVERSION IN COLORECTAL RESECTIONS UNANSWERED QUESTIONS IN RELATION TO TEMPORARY DIVERSION: COMPLICATIONS BEYOND 30 DAYS? LOOP STOMAS OR DOUBLE-BARREL STOMAS? EMERGENCY VS. ELECTIVE PROCEDURES? DIFFERENCES IN THE CONSEQUENCES OF ANASTOMOTIC LEAKS? HOW ARE LEAKS MANAGED?

TEMPORARY FECAL DIVERSION IN COLORECTAL RESECTIONS SET-UP: MULTICENTER PROSPECTIVE AUDIT TIME SPAN: ONE MONTH (?) VARIABLES OF INTEREST: INTRAOPERATIVE: PROCEDURE (LAR, IPAA, SIGMOID RESECTION, ILEOCECAL, ETC.) TME OR CRD LAPAROSCOPIC/ OPEN/ ROBOT/ TAMIS/ SILS HAND-SEWN OR STAPLED ANASTOMOSIS FLUORESCENCE ANGIOGRAPHY/ OMENTOPLASTY/ SEALANTS STOMA: LOOP/ DOUBLE BARREL, ILEOSTOMY/ COLOSTOMY PROPHYLACTIC DRAINAGE OF ANASTOMOSIS/ PELVIS DURATION OF OPERATION PREOPERATIVE: AGE GENDER ASA GROUP BMI SMOKING AND ALCOHOL PREVIOUS ABDOMINAL SURGERY BLOOD TEST RESULTS (HEMOGLOBIN, ALBUMIN, ETC.) PREVIOUS PELVIC RADIOTHERAPY MEDICINE USE PREOPERATIVE BOWEL PREPARATION POSTOPERATIVE: COMPLICATIONS ADMISSION LENGTH READMISSIONS STOMA REVERSAL RATES COMPLICATIONS FOLLOWING STOMA REVERSALS TREATMENT AND OUTCOME OF ANASTOMOTIC LEAKS (BOWEL FUNCTION AT 3 MONTHS/ 1 YEAR?)

THANK YOU! GROUP 2: MARTA DE LA ROSA, ANNA LYONS, RUTGER STIJNS, MICHAEL RYAN, AND ANDERS MARK