Choosing a method for forming preventive intestinal stoma in low anterior rectal resection

The mainstay of rectal cancer treatment is surgery, which includes rectal resection with the creation of a primary or delayed colorectal anastomosis or rectal extirpation. The most severe complication of rectal resection with primary anastomosis is its failure. One of the approaches to reducing the rate of anastomotic failure is the formation of a preventive intestinal stoma, such as an ileostomy or colostomy. To date, there is no consensus on the optimal type of preventive stoma. This study analyzed 12 national and international studies published over the past 5 years. It was found that the existing data on this issue are contradictory and cannot be interpreted unambiguously. Some authors point to the advantages of ileostomy, justifying this choice by a lower incidence of purulent-septic complications, parastomal hernias, and the availability of modern tools for managing peristomal dermatitis, dehydration, and renal insufficiency. Other authors emphasize the significant disruptions in water-electrolyte balance, an inevitable component of postoperative complications associated with ileostomy. Certain studies highlight the clear advantages of transverse colostomy in terms of fewer postoperative complications compared to ileostomy, while others find no differences. These contradictory findings underscore the relevance of this issue and the importance of further research to determine the optimal type of preventive stoma for low anterior rectal resection to achieve satisfactory outcomes in the surgical treatment of rectal cancer patients.

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