Retrospective Analysis Of Laparoscopic Low Anterior Resection Combined With Diverting Loop Ilestomy In Middle And Low Rectal Cancer

Objective:To review the short-term and long-term prognosis of laparoscopic low anterior resection combined with diverting loop ilestomy in low and middle rectal cancer to evaluate the clinical value of ileostomy in rectal cancer.Methods:Retrospective analysis from January 1,2011 to January 1,2015,103 cases of low and middle rectal cancer patients admitted to our department,of which 49patients underwent laparoscopic low anterior resection combined with diverting loop ilestomy,54cases of simple low anterior resection,and compare the differences between the two groups of patients in the short-term and long-term prognosis.Results:Short-term prognosis:There was no significant difference in short-term prognosis between the two groups except for the postoperative hospital stay and anus recovery from defecation discharge.Long-term prognosis:The incidence of anastomotic stricture in the ostomy group was significantly higher than that in the non-stoma group(17.2%,9.4%,P<0.05),and the difference was statistically significant.The first chemotherapy time in the ostomy group(3.3±1.7 months and 1.8±1.2 months,P<0.01)was significantly later than the non-stoma group,the difference was statistically significant;the stoma group and non-stoma group were compared in the rate of rehospitalization(stoma reverse not included)(41.4%,15.6%,P<0.05),the difference was statistically significant.The Wexner anus score:in the postoperative 6 months(10.4 ± 2.8,11.3 ± 2.7,P>0.05),12 months(6.5 ± 2.6,7.0 ± 2.3,P>0.05),24 months(2.5 ± 1.4,3.1 ± 1.5,P>0.05),there was no significant difference between the two groups.Conclusion:1.The loop ilestomy increases the rate of rehospitalization and economic burden;2.The loop ilestomy will bring about a higher incidence of stomy-related complications;3.The loop ilestomy delayed the time of postoperative chemotherapy.