Effect of one-stitch method of temporary ileostomy on the surgical outcomes and complications after laparoscopic low anterior resection in rectal cancer patients: a propensity score matching analysis.

Abstract

Purpose: The purpose of this current study was to explore whether one-stitch method (OM) of temporary ileostomy influenced the surgical outcomes after laparoscopic low anterior resection (LLAR).

Methods: We retrospectively identified rectal cancer (RC) patients who underwent LLAR plus temporary ileostomy in a single teaching hospital from Jan 2011 to June 2023. According to the different methods of ileostomy, the patients were divided into the OM group and the traditional method (TM) group. A propensity score matching (PSM) analysis was performed to eliminate bias and compare the surgical outcomes.

Results: A total of 469 RC patients were included in this study. There were 57 patients in the OM group and 412 patients in the TM group. After 1:1 PSM, there were 57 patients in each group, and no significant difference was found in baseline information (P > 0.05). In terms of surgical outcomes of primary RC surgery, we found that patients in the OM group had shorter operation time (P < 0.01), less blood loss (P < 0.01), and shorter postoperative hospital stay (P < 0.01) than in the TM group after PSM. Moreover, there was no significant difference in both overall complications and stoma-related complications. As for the outcomes of stoma reversal surgery, patients in the OM group had shorter postoperative hospital stay (P = 0.002) than in the TM group before PSM. However, no significant difference was found after PSM (P > 0.05).

Conclusion: The OM of temporary ileostomy was easier, more effective and time-saving than the TM, which did not increase the incidence of both postoperative complications and stoma-related complications.