Diverting Stoma Versus No Diversion in Laparoscopic Low Anterior Resection: A Single-center Retrospective Study in Japan

Abstract

Background/Aim: The purpose of this retrospective study was to describe the benefits and risks of a diverting stoma (DS) in laparoscopic low anterior resection (LAR) for rectal cancer. Materials and Methods: A total of 140 and 167 patients without and with DS, respectively, were included in this study in a high-volume cancer center of Japan within an 8-year period. Results: Small bowel obstruction occurred more frequently in patients with DS (2.86% vs. 16.17%, p<0.001). The difference in anastomotic leakage rate was not statistically significant (11.43% vs. 10.18%, p=0.72). In multivariate analysis, the operating time was associated with a higher rate of leakage in LAR [odds ratio (OR) 8.772, 95% confidence interval (CI)=1.002–1.012, p=0.027]. Conclusion: Operating time was associated with a higher rate of leakage in LAR for low rectal cancer. A DS did not reduce anastomotic leakage but increased the risk of postoperative intestinal obstruction in laparoscopic LAR.