Diverting Ileostomy, Functional Outcome, Middle and Low Rectal Cancer, Stoma Complications
Conditions
Brief summary
Analyze the occurrence of complications, rectal function and quality of life after anus-preserving surgery for middle and low rectal cancer, so as to evaluate the role of protective ileostomy.
Interventions
PROCEDUREDiverting ileostomy
Diverting ileostomy
Sponsors
The First Hospital of Jilin University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
Necessary conditions: meet one of the following conditions 1. Difficult pelvis: narrow pelvis (diameter of ischial tuberosity \<10 cm, diameter of ischial spine \<12 cm) 13 or BMI≥30kg/m2 or tumor diameter≥5cm2. 2. To receive treatment before surgery: preoperative neoadjuvant radiotherapy or concurrent chemoradiation or ESD 3. The anastomosis is below the level of the levator ani muscle: such as ISR, TaTME surgery, etc. Other conditions: 1. Age: 18 to 75 years old, male or female; 2. Preoperative biopsy pathological diagnosis of rectal adenocarcinoma; 3. Received MRI evaluation before surgery, and the distance between the lower edge of the tumor and the anal edge is no more than 10cm; 4. The clinical stage is T1-3N0-2M0; 5. Undertake elective laparoscopic TME for colon-rectal or colon-anal anastomosis 6. ECOG score 0-2; 7. Heart, lung, liver, and kidney functions can tolerate surgery; 8. Patients and their families can understand and are willing to participate in this clinical study, and sign informed consent.
Exclusion criteria
1. Past history of malignant colorectal tumors or recent diagnosis combined with other malignant tumors; 2. Patients with intestinal obstruction, intestinal perforation, intestinal bleeding, etc. who need emergency surgery; 3. Neighboring organs need to be combined with organ removal 4. ASA grade ≥ grade IV and/or ECOG physical status score\> 2 points; 5. Those who have severe liver and kidney function, cardiopulmonary function, blood coagulation dysfunction, or combined with serious underlying diseases that cannot tolerate surgery; 6. Have a history of severe mental illness; 7. Pregnant or lactating women; 8. Those with a history of taking hormone drugs; 9. Patients with other clinical and laboratory conditions considered by the investigator should not participate in the trial.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| comprehensive complication index | 1 year | comprehensive complication index, CCI |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative complications | 1 year | Postoperative complications based on Clavien-Dindo |
| Incidence of anastomotic leakage | 1 year | — |
| Complications related to ileostomy reversal | three months after ileostomy reversal | — |
| Stoma-related complications | 3 months | — |
| Overall Survival | three years after the operation | — |
| Incidence of anastomotic stenosis | 1 year | — |
Contacts
Primary ContactQuan Wang, Prof.
Backup ContactWeihua Tong
Outcome results
None listed