Safety of the stent-based diverting technique after low anterior resection in patients with rectal cancer

<p>Given that anastomotic leakage (AL) is a severe complication of low anterior resection (LAR) for rectal cancer, ileostomy is the most common method for reducing the severity of AL, which in turn has stoma-related side effects. A self-developed technique named the stent-based diverting technique (SDT) not only protects the anastomosis but also avoids the stoma. From December 2021 to March 2023, 80 patients were randomized into the ileostomy arm (n = 43) or the SDT arm (n = 37). Demographic characteristics, laboratory test results, surgical outcomes, and oncological features were compared between the groups. For the primary endpoint, the incidence of severe complications was 14.0% in the ileostomy arm and 8.1% in the SDT arm (relative risk=0.58, 95% confidence interval=0.156-2.163, p=0.494). For the second endpoint, the incidences of mild and total complications were comparable. The shorter the hospital stay, the lower the cost and quality of life, which could be improved by the SDT procedure. This prospective randomized clinical trial preliminarily evaluated the usefulness of SDT after LAR for patients with rectal cancer, suggesting that SDT might be an alternative operation for patients who need to receive ileostomy after rectal surgery.</p>