Safety and Feasibility of Umbilical Stoma After Low Anterior Resection Using Propensity Score Matching

Diverting stoma is often created to decrease the risk of anastomotic leakage following anterior resection with anastomosis, necessitating an additional abdominal wound on the right side for stoma formation. We hypothesized that elevation of the intestinal tract in the umbilicus during resection would reduce the number of wounds. However, few studies have reported complications and management of umbilical stomas. In this study, we examined the short-term outcomes of umbilical stomas and compared them with those of conventional right-sided abdominal stomas. From January 2018 to April 2022, patients who underwent temporary ileostomy during laparoscopic rectal tumor resection and subsequent stoma closure at Saitama Medical University International Medical Center were retrospectively enrolled. Short-term outcomes were analyzed using propensity score matching. A total of 144 patients underwent laparoscopic rectal resection with temporary ileostomy, with 37 and 107 patients in the umbilical and conventional groups, respectively. After propensity score matching, the two groups each included 35 patients and did not differ significantly in terms of patient characteristics. Postoperative complications, including stoma-related complications, did not differ significantly between the groups. However, the operative time for stoma closure was significantly longer in the umbilical group. Umbilical stoma is useful for wound reduction and cosmetic appearance and may be a helpful option for diversion stoma placement after laparoscopic rectal resection.