Imperial College London
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Chris Rao

Faculty of Medicine, Department of Surgery & Cancer

Honorary Clinical Research Fellow
 
 
 
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@article{Gash:2021:10.1111/codi.15531,
author = {Gash, K and Vaughan-Shaw, PG and Brown, J and Adams, K and Valiance, AE and Torkington, J and Morris, K and Cornish, JA and Chambers, A and Stearns, A and Walsh, A and Rankin, A and Khan, A and Morton, A and Engledow, A and Newman, A and Shaw, A and Wilkins, A and Curtis, A and Jones, A and Makhort, A and Groves, A and Bilkhu, A and Alabi, A and Miller, A and Kosti, A and Lyons, A and Sayers, A and Homer, A and Soares, AS and Williams, A and Oglesby, A and Abdelmabod, A and Silva, ANS and Pannu, A and Khan, A and Stubbs, B and Vadhwana, B and Cruz, C and El-Sayed, C and Currow, C and Bowman, C and Liao, C and Rao, C and Halkias, C and Glancy, D and Anderson, D and Bowden, D and Zosimas, D and Waugh, D and Speake, D and Scrimgeour, D and Monaghan, E and Crossley, E and Alkizwini, E and Barron, E and Blower, E and Kastanias, E and Mosley, F and Ugwu, F and Faulkner, G and Gossedge, G and Ramsay, G and Lloyd, G and Williams, G and Preziosi, G and McAdam, G and Taylor, G and Boyd-Carson, H},
doi = {10.1111/codi.15531},
journal = {Colorectal Disease},
pages = {1--11},
title = {Factors impacting time to ileostomy closure after anterior resection: the UK closure of ileostomy timing cohort study (CLOSE-IT)},
url = {http://dx.doi.org/10.1111/codi.15531},
year = {2021}
}
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TY  - JOUR
AB  - AimDelay to closure of ileostomy following anterior resection for rectal cancer may impair postoperative bowel function and quality of life. We analysed time to ileostomy closure across the UK and investigated factors delaying closure.MethodsFor the retrospective cohort we assessed time to closure and incidence of nonclosure for patients who underwent anterior resection with defunctioning ileostomy during 2015. Multivariate linear/Cox regression analyses were performed. For the prospective cohort we captured patients undergoing ileostomy closure during a 3month period in 2018 to validate retrospective findings.ResultsThe retrospective cohort involved 788 patients of whom 669 (84.9%) had bowel continuity restored, median time to closure 259 days. Recognized factors associated with delay and risk of nonclosure included anastomotic leak (hazard ratio [HR] 3.65, 2.61–5.08), chemotherapy (HR 2.62, 2.17–3.15) and cancer progression (HR 2.05, 1.62–2.58). Crucially, specific aspects of the surgical pathway were associated with time to closure; for example, waiting list entry prior to outpatient clinic review/imaging was associated with an estimated 133day shorter interval to closure (P < 0.001). In the prospective cohort 288 patients underwent closure, at a median of 271 days. Chemotherapy use and cancer progression were associated with delay to closure while listing for surgery prior to clinic and imaging was associated with an estimated shorter interval to closure of 168 days (P = 0.008).ConclusionsDelays to closure of ileostomy are common in the UK. Listing patients for surgery only after followup outpatient appointment, imaging or chemotherapy delays closure. Findings will inform consensus guidelines towards an optimum treatment pathway to reduce delay and improve postclosure quality of life.
AU  - Gash,K
AU  - Vaughan-Shaw,PG
AU  - Brown,J
AU  - Adams,K
AU  - Valiance,AE
AU  - Torkington,J
AU  - Morris,K
AU  - Cornish,JA
AU  - Chambers,A
AU  - Stearns,A
AU  - Walsh,A
AU  - Rankin,A
AU  - Khan,A
AU  - Morton,A
AU  - Engledow,A
AU  - Newman,A
AU  - Shaw,A
AU  - Wilkins,A
AU  - Curtis,A
AU  - Jones,A
AU  - Makhort,A
AU  - Groves,A
AU  - Bilkhu,A
AU  - Alabi,A
AU  - Miller,A
AU  - Kosti,A
AU  - Lyons,A
AU  - Sayers,A
AU  - Homer,A
AU  - Soares,AS
AU  - Williams,A
AU  - Oglesby,A
AU  - Abdelmabod,A
AU  - Silva,ANS
AU  - Pannu,A
AU  - Khan,A
AU  - Stubbs,B
AU  - Vadhwana,B
AU  - Cruz,C
AU  - El-Sayed,C
AU  - Currow,C
AU  - Bowman,C
AU  - Liao,C
AU  - Rao,C
AU  - Halkias,C
AU  - Glancy,D
AU  - Anderson,D
AU  - Bowden,D
AU  - Zosimas,D
AU  - Waugh,D
AU  - Speake,D
AU  - Scrimgeour,D
AU  - Monaghan,E
AU  - Crossley,E
AU  - Alkizwini,E
AU  - Barron,E
AU  - Blower,E
AU  - Kastanias,E
AU  - Mosley,F
AU  - Ugwu,F
AU  - Faulkner,G
AU  - Gossedge,G
AU  - Ramsay,G
AU  - Lloyd,G
AU  - Williams,G
AU  - Preziosi,G
AU  - McAdam,G
AU  - Taylor,G
AU  - Boyd-Carson,H
AU  - Copley,H
AU  - Naheswaran,H
AU  - Black,H
AU  - Ferguson,H
AU  - Koh,H
AU  - Jones,H
AU  - Lord,I
AU  - Reece,I
AU  - Foster,J
AU  - Pitt,J
AU  - Shabbir,J
AU  - Sarveswaran,J
AU  - Sagar,J
AU  - Foot,J
AU  - Allison,J
AU  - Hilton,J
AU  - Deery,J
AU  - Fallon,J
AU  - Lund,J
AU  - Easterbrook,J
AU  - Fletcher,J
AU  - Bailey,J
AU  - Huang,J
AU  - John,J
AU  - Roy,J
AU  - Leong,K
AU  - Sahnan,K
AU  - Hodson,K
AU  - Cross,K
AU  - Hobson,K
AU  - Siggens,K
AU  - Keogh,K
AU  - Hureibi,K
AU  - Hashmi,K
AU  - Muirhead,L
AU  - Kennedy,L
AU  - Sheahlin,L
AU  - Reza,L
AU  - Pippard,L
AU  - Dickerson,L
AU  - Stevenson,L
AU  - Chand,M
AU  - Chan,M
AU  - Yiasemidou,M
AU  - Wiggans,M
AU  - Boal,M
AU  - Feretis,M
AU  - Saunders,M
AU  - Shinkwin,M
AU  - Thornton,M
AU  - Williamson,M
AU  - Elshaer,M
AU  - Rabie,M
AU  - Fakhrul-Aldeen,M
AU  - Harilingam,M
AU  - Francis,N
AU  - Curtis,N
AU  - Smart,N
AU  - Fearnhead,N
AU  - Symons,N
AU  - Reay-Jones,N
AU  - Marks,N
AU  - Eardley,N
AU  - Nanjappa,N
AU  - Pawa,N
AU  - Husnoo,N
AU  - Warren,O
AU  - James,O
AU  - Mackey,P
AU  - Sutton,P
AU  - Herrod,P
AU  - Orchard,P
AU  - Tozer,P
AU  - Persson,P
AU  - Lokanathan,P
AU  - Falconer,R
AU  - Thomas,R
AU  - Harshen,R
AU  - Kushwaha,R
AU  - Maahi,R
AU  - Bhardwaj,R
AU  - Radwan,R
AU  - Oliphant,R
AU  - Bourdon-Pierre,R
AU  - Fallaize,R
AU  - Iddles,R
AU  - Kelleher,R
AU  - Rai,S
AU  - Mehmood,S
AU  - Arman,S
AU  - Granger,S
AU  - Lawday,S
AU  - Bhandari,S
AU  - Duff,S
AU  - Rehman,SFU
AU  - Rehman,S
AU  - Mitra,S
AU  - Lockwood,S
AU  - Doran,S
AU  - Pilkington,S
AU  - Shepherd,S
AU  - Dilke,S
AU  - Lindley,S
AU  - Chandler,S
AU  - Moug,S
AU  - Ross,T
AU  - Hussain,T
AU  - Roe,T
AU  - Hettiarachchi,T
AU  - Mcbride,T
AU  - Walsh,U
AU  - Kulikova,V
AU  - Hariharan,V
AU  - Datta,V
AU  - Kenworthy,W
AU  - Ibrahim,Y
AU  - Thackray,Y
AU  - Karar,S
AU  - Baker,K
DO  - 10.1111/codi.15531
EP  - 11
PY  - 2021///
SN  - 1462-8910
SP  - 1
TI  - Factors impacting time to ileostomy closure after anterior resection: the UK closure of ileostomy timing cohort study (CLOSE-IT)
T2  - Colorectal Disease
UR  - http://dx.doi.org/10.1111/codi.15531
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000619156200001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://onlinelibrary.wiley.com/doi/10.1111/codi.15531
ER  -
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