Application of modified colostomy under subcutaneous placement of partial cecal wall in anterior resection for low rectal cancer

Objective To evaluate the value of modified colostomy under subcutaneous placement of partial cecal wall in anterior resection for low rectal cancer. Methods A retrospective analysis of twenty -four patients with low rectal cancer admitted to Zibo Central Hospital from June 2012 to April 2017 was performed. Patients were treated with modified colostomy under subcutaneous placement of partial cecal wall in anterior resection for low rectal cancer. Postoperative incision infection, anastomotic fistula and defecation were analyzed to evaluate the value of this operation with long-term follow-up. Results There were 2 cases of incision infection; 3 cases of pure anastomotic fistula (including 1 case of long-term hormone taking), of whom 1 case was cured with conservative treatment, 2 caes with open colostomy; 1 case with rectovaginal fistula who was cured by conservative treatment. Two weeks after surgery, 17 cases had defecation 5-12 times/d, 7 cases less than or equal to 4 times/d. One month after surgery, all patients could predict and control the defecation. Three months after surgery, defecation was less than 4 times/d. Six months after surgery, 22 cases had defecation 1-3 times/d, 2 cases with waste spills. The patients were followed up for 6 months to 3 years after discharge. Anastomotic stenosis occurred in 1 case, local recurrence in 2 cases, distant metastasis in 3 cases, and death in 2 cases. Conclusions The modified stoma has the advantages of simple operation, safety and effectiveness. If the postoperative recurrence leads to obstruction, it will be easier for reoperation again. Key words: Rectal neoplasms; Enterostomy; Anastomotic leak; Preserving anus