Postoperative Effects of Different Enterostomy Approaches

Inclusion criteria

• Pathological confirmed adenocarcinoma of the rectum;
• Patients age between 18-80;
• Baseline AJCC stage I-III: cT1-4N0-2M0 (AJCC-8 version);
• Eastern Cooperative Oncology Group (ECOG) physical status score of 0 to 2;
• Patients voluntarily sign informed consent.

Exclusion criteria

• Other types of rectal cancer (adenosquamous carcinoma, squamous carcinoma, neuroendocrine tumors, clear cell carcinoma, spindle cell carcinoma, undifferentiated carcinoma);
• Combination of rectal cancer with multiple carcinomas;
• Pre-operative presence of acute and chronic infectious diseases or foci of infection;
• Intraoperative radical surgery was not performed for various reasons；
• Colostomy was not performed at the same time as the radical rectal cancer surgery;
• Combined with intestinal obstruction, intestinal perforation, intestinal bleeding, peritonitis, etc. requiring emergency surgery;
• Metastatic cancer;
• Serious heart, lung, liver and kidney disease, can not tolerate surgery;
• Active liver disease or abnormal liver function with ALT, AST and TBIL more than 2 times the upper limit of normal values;
• Renal impairment with Cr ≥ 2 times the upper limit of normal or BUN ≥ 2 times the upper limit of normal;
• Blood leukocytes below the lower limit of normal value, or platelets below the lower limit of normal value, or with other blood system diseases;
• Pregnancy;
• Mental illness or serious intellectual disability who cannot describe their feelings correctly;
• Severe coagulation disorder, bleeding tendency;
• Patients with severe uncontrolled medical disease, recent history of myocardial infarction (within 3 months), uncontrolled severe hypertension and severe diabetes mellitus;
• Patients need to be on antibiotics/other probiotics for a long time.