REVIEW OF DECOMPRESSION ILEOSTOMY DURING LAPAROSCOPIC RECTAL CANCER SURGERY

Introduction: Decompression ileostomy is always applied to avoid clinically signicant anastomotic leakage and other postoperative complications for patients receiving laparoscopic rectal cancer surgery. However, whether it is necessary to perform the ileostomy is still controversial. This analysis aims to analyse the efcacy of ileostomy on laparoscopic rectal cancer surgery. Methods: Cochrane Library, EMBASE, Web of Science, and PubMed were applied for systematic search of all relevant literature, updated to March 31, 2022. Studies compared patients with and without ileostomy for laparoscopic rectal cancer surgery. The analysis was performed using Review Manager software. The quality of the non-randomized controlled trials was assessed using the Newcastle-Ottawa scale (NOS), and the randomized studies were assessed using the Jadad scale. Results: A total of 1203 references were obtained, and 7 studies were included using the research methods. The clinically signicant anastomotic leakage rate was signicantly lower in ileostomy group (27/567, 4.76%) than that in non-ileostomy group (54/525, 10.29%) (RR = 0.47, 95% CI 0.30–0.73, P for overall effect = 0.0009, P for heterogeneity = 0.18, I2 = 32%). However, the postoperative hospital stay, reoperation, wound infection, and operation time showed no signicant difference between the ileostomy and non-ileostomy groups. Conclusion: The results demonstrated that protective ileostomy can decrease the clinically signicant anastomotic leakage rate for patients undergoing laparoscopic rectal cancer surgery. However, ileostomy has no effect on postoperative hospital stay, reoperation, wound infection, and operation time