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Objective <p>This study compared the safety and functional outcomes of prophylactic loop ileostomy (LI) versus transverse end colostomy (TEC) after laparoscopic radical resection for rectal cancer.</p> Methods <p>In this single-center retrospective study, 171 patients requiring a prophylactic stoma were divided into LI (n = 93) and TEC (n = 78) groups. Primary endpoints were anastomotic leakage (AL) and AL-related reoperation rates within 3&#xa0;months.</p> Results <p>The AL rate was comparable between groups (LI 2.2% vs TEC 1.3%, p = 1.0). However, all leaks in the LI group required reoperation, versus none in the TEC group. The overall complication rate was higher in the LI group (39% vs 15%, p &lt; 0.05), driven mainly by electrolyte disturbances (32% vs 11%, p &lt; 0.05). LI was associated with shorter operative times for both initial stoma creation and subsequent reversal (both p &lt; 0.05). Among the 144 patients who underwent stoma reversal, incisional hernia occurred only in the LI group (4/78 vs 0/66, p = 0.12).</p> Conclusion <p>TEC is a non-inferior alternative associated with a lower reoperation risk for AL and fewer metabolic complications, whereas LI offers shorter operative times. The choice depends on weighing procedural efficiency against long-term stoma-related risks.</p>

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A single-center retrospective study of prophylactic loop ileostomies and transverse end colostomies after laparoscopic radical resection for rectal cancer: a comparison of safety and functional outcomes

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月14日

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  • Yanzhi Li,
  • Zhenrong Gao,
  • Chao Yue,
  • Yannian Wang,
  • Xuanning Qiao,
  • Ruiqi Gao,
  • Huijun Shen,
  • Xiaoxia Zhang,
  • Jianan She,
  • Wenpeng Fan,
  • Ying Zhang,
  • Xiaohua Li

摘要

Objective

This study compared the safety and functional outcomes of prophylactic loop ileostomy (LI) versus transverse end colostomy (TEC) after laparoscopic radical resection for rectal cancer.

Methods

In this single-center retrospective study, 171 patients requiring a prophylactic stoma were divided into LI (n = 93) and TEC (n = 78) groups. Primary endpoints were anastomotic leakage (AL) and AL-related reoperation rates within 3 months.

Results

The AL rate was comparable between groups (LI 2.2% vs TEC 1.3%, p = 1.0). However, all leaks in the LI group required reoperation, versus none in the TEC group. The overall complication rate was higher in the LI group (39% vs 15%, p < 0.05), driven mainly by electrolyte disturbances (32% vs 11%, p < 0.05). LI was associated with shorter operative times for both initial stoma creation and subsequent reversal (both p < 0.05). Among the 144 patients who underwent stoma reversal, incisional hernia occurred only in the LI group (4/78 vs 0/66, p = 0.12).

Conclusion

TEC is a non-inferior alternative associated with a lower reoperation risk for AL and fewer metabolic complications, whereas LI offers shorter operative times. The choice depends on weighing procedural efficiency against long-term stoma-related risks.