Outcomes of Protective Ileostomy Closure during versus after Adjuvant Chemotherapy Following Rectal Cancer Surgery

Introduction: A diverting ileostomy lowered the rate of anastomotic leaks and reoperation, but there are manyhealth issues that can happen because of stomas. Chemotherapy can weaken the immune system and makethe body’s functions worse, which can increase the chances of postoperative adverse events. Also, interruptionof chemotherapy can lower the overall survival. This research reviews the surgical and oncological outcomes ofileostomy closure during and after the adjuvant therapy.Patients and methods: A retrospective analysis was done on patients who underwent rectal cancer resectionwith a diverting ileostomy and received adjuvant chemotherapy between January 2017 and January 2022. Twogroups of cases were made: group A had early ileostomy reversal during adjuvant chemotherapy, which involved96 patients; and group B had closure after adjuvant chemotherapy, which involved 72 patients.Results: Patients of both groups had similar demographic characteristics, while group B included more patientswith low rectal cancers (P= 0.040). The longer duration of ileostomy was associated with higher stoma-relatedmorbidities [14 (14.6%) vs. 26 (36.1%) and P= 0.002]. The rate of overall postoperative morbidities [17 (23.6%)in late closure group vs. 20 (20.8%) in group A]. Both groups revealed comparable results for the recurrence-freesurvival rate and the overall survival outcomes.Conclusion: Ileostomy closure during adjuvant chemotherapy could achieve the same clinical and oncologicalsafety as late closure, while reducing stoma-related morbidities. Careful patient selection should be consideredbased on individual patient factors, and adjuvant treatment considerations.