One-stitch method vs. traditional method of protective loop ileostomy for rectal cancer: the impact of BMI obesity

Abstract

Purpose

Protective loop ileostomy is an effective diversion measure often used to reduce the risk of anastomotic leakage. The purpose of the present study was to evaluate the surgical outcomes of the one-stitch method (OM) of protective loop ileostomy in laparoscopic low anterior resection for BMI obesity patients with rectal cancer compared with the traditional method (TM).

Methods

The patients diagnosed as rectal adenocarcinoma cases by preoperative pathology were included in this retrospective study. The subjects underwent protective loop ileostomy in laparoscopic low anterior resection from January 2016 to June 2019 in the Shandong Provincial Hospital affiliated to Shandong University. The data of loop ileostomy and stoma closure operation were retrieved from the medical cases system of the hospital.

Results

242 patients were included in the present study. In the BMI obese cohort, the OM group showed a shorter operative time both in the loop ileostomy (232.5 vs. 250.0 min, p = 0.04) and stoma closure operation (102.5 vs. 115.0 min, p = 0.001) and a lower peristomal adhesion extent (p = 0.02) and a shorter median postoperative stay (6 vs. 7 days, p = 0.03) during stoma closure operation than that of the TM group. In the TM group, obese cases showed a higher operative time of stoma closure operation (115.0 vs. 95.0, p < 0.001), a higher parastomal hernia rate (p = 0.04), a higher peristomal adhesion extent (p = 0.005) and a longer postoperative stay of stoma closure operation (p = 0.02) compared with the non-obese cases, while in the OM group, no significant differences were observed between the obese and non-obese cases in terms of the above-mentioned factors.

Conclusions

The OM exhibited more advantages than TM, notably in BMI obesity patients.

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Acknowledgements

We would like to thank all of the members of the Department of Gastrointestinal Surgery of Shandong Provincial Hospital Affiliated to Shandong First Medical University for thought-provoking discussion and collegial support in this study.

Funding

Financial support for this study was provided by the National Natural Science Foundation of China (Grant No. 81702363), Shandong Provincail  Natural Scienece Foundation (ZR2020MH209), and Shandong Key Research and Development Program (Grant 2019GSF108161).

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Authors

Contributions

JZ designed the study program. HC and WP were major contributors in writing the manuscript. ZL, XZ, YC, FZ and HZ collected patient-related data. LL, CJ, and TX analyzed and interpreted the patient data. JZ, LL, LP and HC revised it critically for important intellectual content. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jizhun Zhang.

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The authors declare no conflict of interest.

Availability of data and material

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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The study is retrospective, according to Ethical Review of Human Biomedical Research (CN), the study was recorded by the Ethics Committee of the Shandong Provincial Hospital Affiliated to Shandong First Medical University, and all patients signed informed consent.

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All of the patients included in the present study signed informed consent and consented to participate in the study.

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Pei, W., Cui, H., Liu, Z. et al. One-stitch method vs. traditional method of protective loop ileostomy for rectal cancer: the impact of BMI obesity. J Cancer Res Clin Oncol (2021). https://doi.org/10.1007/s00432-021-03556-z

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Keywords

  • Rectal cancer
  • Laparoscopic low anterior resection
  • Protective loop ileostomy
  • One-stitch method
  • BMI obesity