BACKGROUND: This study sought to determine whether a protective diverting ileostomy improves short-term outcomes in @entity1 with rectal resection and @entity694 reconstruction for low anastomoses. Criteria for the use of a proximal stoma in rectal resections with @entity694 reconstruction have not been defined sufficiently. METHODS: In a multicenter prospective study, @entity5 @entity1 with anastomoses below 8  cm treated with low anterior resection and @entity694 were randomized to a defunctioning loop ileostomy or no ileostomy. The primary study endpoint was the rate of @entity834 , and the secondary endpoints were surgical complications related to primary surgery, stoma, or stoma closure. RESULTS: From 2004 to 2014, a total of 166 @entity1 were randomized to 1 of the 2 study groups. In the intention-to-treat analysis, the overall leakage rate was 5.8% in the stoma group and 16.3% in the no stoma group (P  =  .0441). However, some @entity1 were not treated according to randomization and only 70% of our @entity1 with low anastomoses received a pouch. Therefore, we performed a second analysis as to actual treatment. In this analysis, as well, leakage rates (P  =  .044) and reoperation rates for leakage (P  =  .021) were significantly higher in @entity1 without a stoma. In multivariate analysis, male gender (P  =  .0267) and the absence of a stoma (P  =  .0092) were significantly associated with @entity834 . CONCLUSION: Defunctioning loop ileostomy should be fashioned in @entity5 @entity1 with anastomoses below 6  cm, particularly in male @entity1 , even if reconstruction was done with a @entity2418 .

Diverting ileostomy versus no diversion after low anterior resection for XXXX : A prospective, randomized, multicenter trial.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity834 :: ('MESH:D057868', 'Disease') :: ['anastomotic leakage'] @entity2418 :: ('MESH:D004062', 'Disease') :: ['J-pouch'] @entity5 :: ('MESH:D009369', 'Disease') :: ['rectal cancer'] @entity694 :: ('MESH:D003110', 'Disease') :: ['colonic J-pouch']
@entity5 :: (MESH:D009369,Disease) :: ['rectal cancer']
