Application study of an autologous tissue scaffold technique for ileostomy via a lower midline specimen extraction incision in low anterior resection for rectal cancer
ZHENG Zhong-qiang
QIU Guang-lin
CAI Lin-di
WANG Hui-jun
LIAO Xin-hua
CHE Xiang-ming
LI Xu-qi
FAN Lin
Abstract：Objective To investigate the clinical value of prophylactic ileostomy using an autologous tissue scaffold technique via a lower midline specimen extraction incision in low anterior resection for rectal cancer.Methods Clinical data of 66 rectal cancer patients who underwent low anterior resection with prophylactic ileostomy at the Department of General Surgery,First Affiliated Hospital of Xi'an Jiaotong University from January 2021 to December 2023 were retrospectively analyzed.Patients were divided into observation group(autologous tissue scaffold technique,n=25)and control group(conventional technique,n=41)based on surgical approach.Comparisons included stoma creation time,intraoperative blood loss,postoperative recovery parameters,and complication rates.Results No significant differences were observed in baseline characteristics between groups(P＞0.05).The observation group demonstrated significantly shorter stoma creation time[(10.16±4.27)min vs.(19.63±3.84)min,P＜0.001],earlier postoperative gastrointestinal function recovery[(2.04±0.73)d vs.(2.41±0.59)d,P=0.026],and reduced stoma reversal incision length[(5.26±0.86)cm vs.(5.87±0.85)cm,P=0.007].Notably,the observation group showed significantly lower incidence of moderate-to-severe abdominal adhesions(24.0％vs.53.7％,P=0.018).Although the observation group had higher parastomal hernia incidence(24.0％vs.2.4％,P=0.019),all cases were occult hernias detected intraoperatively and repaired without increasing reoperation risk.No significant differences were found in complications like effluent dermatitis or stoma retraction(P＞0.05).Conclusion The autologous tissue scaffold technique via lower midline incision shortens operative time for stoma creation and reversal while reducing abdominal adhesion risks.Although potentially increasing occult parastomal hernia incidence,this approach maintains favorable clinical outcomes and represents an optimal strategy for prophylactic ileostomy.
Keywords：rectal cancerprophylactic ileostomyautologous tissue scaffold methodlow anterior resectionintra-abdominal adhesionsparastomal herniaminimally invasive surgeryenhanced recovery after surgery
Publication Date：2025-06-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 691-697 )