Influence Of Preventive Terminal Ileum Stoma On Life Quality And Defecation Of Patients Underwent Sphincter Preservation For Rectal Cancer

Objective: To investigate the influence of preventive terminal ileum stoma ondefecation and quality of life in low rectal cancer.Methods: Retrospectively analyzed clinical data from patients with low rectalcarcinoma who had underwent sphincter preservation from January2010to December2011,in Liaoning Cancer Hospital. All these patients undergoing low anterior rectalresection should be confirmed by the electronic colonoscope examination and thebiopsy. In addition, the distance of the tumor from the anal verge of them should lessthan8cm.More over, we should except those ones who had bothered by anemia,hyporproteinemia, diabetes, heart diseases and so on. Then, they were categorized into2groups according to the preventive terminal ileum stoma (A:received preventiveterminal ileum stoma, B: none stoma).Thirty patients had been respectively chosen foreach group. All cases of A group had a closure of their temporary stoma after threemonths after primary surgery. Finally, we respectively evaluated these cases with XuZhongfa’s evaluation criteria, stoma scoring systems (SSS), and the Short-Form36(SF-36) at two weeks,3months,3.5months, and6months after primary operation.Results: No differences of SF-36scores were detected between A group and Bgroup at2weeks after primary operation（PCS：P=0.001; MCS:P=0.033）,both the twogroups had bad effects in quality of life. Conversely, at3months after operation, Agroup has had significantly higher scores. However, compared with A group, B grouphad higher scores of PCS（P<0.001）at3.5mo after first operation, but as for MCS andXu Zhongfa’s evaluation criteria, the major criterion was identical in the two groups.At6mo after operation, B group showed a statistically significant improvement in lifequality（PCS：P<0.001; MCS:P<0.001）and defecation（P=0.001）of patients.Otherwise, there was one hernia happened in A group, and three anastomotic leakage in B group.Conclusions: The preventive ileostomy undoubtedly decreased the long-termsurvival quality of life in patients undergoing low anterior resection for rectal cancer,and particularly promoted the recovery of the defecation function．The method, however,need more evidence, should not be abused.