Defunctioning Left-sided Colostomy in Low Anterior Resection for Rectal Cancer

Defunctioning Left-sided Colostomy in Low Anterior Resection for Rectal Cancer

This is prospective, multi centre study evaluating a novel type of defunctioning loop stoma after low anterior resection for rectal cancer. Patients will be operated with a complete splenic flexure mobilisation and total mesorectal excision. An anastomosis will be fashioned at the pelvic floor. This will leave a redundant colon which will be brought up and matured in the left iliac fossa. Patient bowel function and quality of life will be monitored at baseline and at one year postoperatively, when the stoma will typically have been reversed. Dehydration and kidney injury are expected to become infrequent in comparison with the main alternative loop ileostomy. About 20 patients will be included in this pilot study.

Inclusion Criteria:

• Age ≥18 years
• Capacity for informed consent
• Planned defunctioning stoma
• Planned mesorectal excision with anastomosis for rectal cancer

Exclusion Criteria:

• Manifest atherosclerotic disease (peripheral vascular disease, previous myocardial infarction, angina, etc)
• Previous oncological colonic resection
• Defunctioning stoma in situ
• Intraoperative event leading to bowel resection and subsequent inability to bring out left-sided colostomy without tension on the anastomosis
• Intraoperative circumstances as judged by the operating surgeon leading to unacceptable risks due to loop colostomy placement (abdominal wall size, short mesentery, other preconditions)