CLOSE-IT
Research type
Research Study
Full title
Closure of ileostomy timing study
IRAS ID
239610
Contact name
Julie Cornish
Contact email
Sponsor organisation
Cwm Taf University Health Board
Duration of Study in the UK
0 years, 6 months, 1 days
Research summary
Over the last decade the surgical approach to rectal cancer has significantly changed, with greater emphasis on sphincter preservation and a reduction in the rate of abdominoperineal resections. A sphincter sparing anterior resection is the gold standard for mid to low rectal cancers, with low anastomoses often defunctioned with a loop ileostomy. The National Bowel Cancer Audit’s (NBOCA) report in 2015, highlighted that 77% of all patients undergoing an Anterior Resection had a stoma formed. As 5 year survival rates have improved for rectal cancer, there is an increasing emphasis on the issues facing patients following their cancer treatment. A recent report from the Department of Health with the UK National Bowel Cancer Survivorship initiative suggested that almost 1 in 5 patients have significant bowel dysfunction following surgery. Anterior resection syndrome is defined as “disordered bowel function after rectal resection, leading to a detriment in quality of life”. Symptoms range from bowel fragmentation and emptying difficulties to faecal urgency and incontinence. The term low anterior resection syndrome (LARS) is becoming more commonly used as there is an association with low anastomoses. A recent study suggested that delays in closure of ileostomy more than 6 months were associated with a 3.7 fold increase risk of major LARS symptoms. Although the timing of the initial cancer surgery is monitored with targets set, the timing of the reversal is not subject to targets and there is considerable variation in the UK. In Europe and the USA late closure is considered to be > 3 months after initial surgery however in the UK 27% of patients still have a stoma at 18 months post operatively. The aim of this study is to assess the timings of closure of ileostomies in the UK and assess if service issues play a role in any delay of closure.
REC name
South West - Cornwall & Plymouth Research Ethics Committee
REC reference
18/SW/0024
Date of REC Opinion
31 Jan 2018
REC opinion
Favourable Opinion