Defunctioning Stoma In Low Anterior Resection For Rectal Cancer

Objective:This meta-analysis evaluates the necessity of a defunctioning stoma in low anterior resection for rectal cancer.Methods:Studies and relevant literatures regarding the defunctioning stoma in low anterior resection for rectal cancer published from January2000to May2013were searched computer retrieval method though PubMed, Medline,EMbase,Wanfang,CNKI and CBM,and manual retrieval, Chinese and English published material and conference papers and recover the paper of literature references, and use RevMan5.1software Meta analysis.Results:Three RCTs with524cases(270patients with defunctioning stoma and254without stoma) and17retrospective controlled trials with9102cases(3705patients with defunctioning stoma and5397without stoma) were included.Meta-analysis of the RCTs showed a lower clinical anastomotic leak rate(RR=0.31,95%CI:0.18-0.52;P<0.05)and a lower reoperation rate(RR=0.31,95%CI:0.17-0.59;.P<0.05) in the defunctioning stoma group.Meta-analysis of retrospective controlled trials showed a lower clinical anastomotic leak rate (OR=0.63,95%CI:0.43-0.91;P<0.05),lower reoperation rate(OR=0.30,95%CI:0.23-0.38;P<0.05) and lower mortality rate (OR=0.45,95%CI:0.28-0.74;P<0.05) in the defunctioning stoma group. Conclusion:A defunctioning stoma decreases clinical anastomotic leak rate and reoperation rate. It is recommended after low anterior for rectal cancer.