Application of preventive flap-placement of terminal ileostomy in laparoscopic radical resection of low rectal cancer

Abstract

Objective: To evaluate the value of preventive flap placement of terminal ileostomy in laparoscopic radical resection of low rectal cancer. Methods: A retrospective analysis was conducted in the patients (n=63) who received preventive terminal ileostomy in laparoscopic radical resection of low rectal cancer in our institution from April 2016 to March 2018, including 33 patients who underwent ileostomy with flap-placement (flap group), and 30 patients who underwent ileostomy with stent (stent group). Clinical data were collected from both groups and statistically analyzed. Results: All patients were successfully completed laparoscopic radical resection with preventive ileostomy. All patients of stent group received stoma-closure surgery one month later after rectal resection. There were significantly statistical differences in operating time of ileostomy (28.9±4.3 vs 36.3±2.3, t=11.73, P<0.001) and overall stoma-related complications (1 vs 7, χ(2)=4.155, P=0.042), but no difference in anastomosis leakage, operating time of stoma-reversal, parastomal infection, parastomal hernia and parastomal prolapse. Conclusions: Preventive flap placement of terminal ileostomy represents a secure and feasible approach to laparoscopic low rectal cancer resection. Patients can be released from the discomfort of removing the stent and may suffer fewer stoma-related complications.