Protective Ileostomy After Low Anterior Resection for Rectal Cancer: Modifying the Clinical Course of Anastomotic Leakage at the Cost of Stoma-Related Morbidity
Retrospective analysis evaluates the effects of protective ileostomy on anastomotic leakage outcomes in rectal cancer patients, suggesting improved management but increased morbidity.
Key Points
This study aims to evaluate the effects of protective ileostomy on the clinical outcomes of anastomotic leakage following low anterior resection for rectal cancer.
Retrospective review of patients who underwent total mesorectal excision with low anterior resection post-neoadjuvant therapy.
Patients were grouped into LAR alone (n = 10) and LAR + protective ileostomy (n = 74).
Main outcomes assessed included anastomotic leakage incidence, severity, management, mortality, and protective ileostomy-related morbidity.
Anastomotic leakage occurred in 5.9% of patients, showing no significant difference between groups (LAR 10.0% vs LAR + PI 5.4%; P = 0.478).
Leak-related mortality was observed in 1 LAR patient, with no cases in the PI group.
Length of hospital stay was significantly longer for the PI group (median 10.0 days) compared to LAR alone (7.5 days; P < 0.001).