Time to closure (reversal) of temporary ileostomy following anterior resection for rectal cancer

Abstract

Aim: Delay to closure (reversal) of temporary ileostomy following anterior resection for rectal cancer may be associated with poorer bowel function and quality of life once continuity is restored. Interval to ileostomy closure in the UK is markedly higher than in other developed healthcare systems. This multicentre study will assess time to ileostomy closure and reasons for delay to closure. Results will inform consensus guidelines on optimum treatment pathways following ileostomy formation thereby streamlining care and reducing delays in closure. Patients: Patients with a defunctioning ileostomy following anterior resection for rectal cancer. Comparator None. Outcomes: Outcomes will include the following: Average time to ileostomy closure National and regional variation in time to ileostomy closure Incidence of nonclosure across the UK and by centre Factors impacting time to closure Pathways and processes facilitating timely closure Study design: The study will be conducted through collaboration with members of the Dukes club (the trainee arm of the ACPGBI) and the National Research Collaborative. There will be two parts to the study; a prospective 3month data collection of all patients undergoing closure of ileostomy following a previous anterior resection for rectal cancer a retrospective capture of patients who underwent anterior resection with ileostomy formation over a 12month period in 2015. Data will be collected from electronic hospital and theatre records, MDT notes and radiology imaging systems. Case Report Forms will capture information on patient demographics, oncological details, surgical history and outcomes. Surgeon and patient preference or system delays such as bed shortages or service pressures due to competing national targets will also be sought. Finally, all participating units will be surveyed to determine local clinical and management protocols and barriers to timely closure.