To compare the efficacy of two prophylactic ileostomy in the treatment of ultra-low rectal cancer by laparoscopic transsphincteric resection (ISR).

A total of 120 patients with ultra-low rectal cancer who received laparoscopic ISR treatment from June 2019 to June 2022 were selected as the study objects, and the patients were divided into three acupuncture groups and one acupuncture group by random number table method, with 60 cases in each group. Prophylactic ileostomy was performed after laparoscopic ISR in both groups, with three needles in the three-needle group and one needle in the one-needle group. The data was processed by SPSS 22.0. Perioperative indicators, pain score, anal incontinence function score (Wexner) and other measurement data were expressed by (). Independent sample t test or repeated measurement ANOVA were performed. The statistical data of postoperative complications were expressed by [cases (%)] and χ² or Fisher test was performed. P<0.05 was considered statistically significant.

The time of operation and the time of stomatization in the three-needle group were significantly higher than those in the one-needle group (P<0.05), and the postoperative VAS score was significantly lower than that in the one-needle group (P<0.05). There was no significant difference in intraoperative blood loss, anal exhaust time, postoperative hospital stay and stomatectomy time between the two groups (P>0.05). No postoperative anastomotic leakage occurred in both groups, but the total incidence of postoperative ostomy-related complications in the three-needle group was significantly lower than that in the one-needle group (6.7% vs. 20.0%, P<0.05), and the incidence of postoperative ostomy prolapse was significantly lower than that in the one-needle group (0.0% vs. 10.0%, P<0.05). After transanal defecation, patients in both groups had poor defecation control and increased defecation frequency to varying degrees, and defecation conditions were improved with the passage of time, the difference was statistically significant (P<0.05), but there was no statistically significant difference between the two groups at the same time (P>0.05).

Both three-needle and one-needle prophylactic ileostomy are safe and effective in laparoscopic ISR treatment of ultra-low rectal cancer. Although the operation time and stomy time of three-needle prophylactic ileostomy are slightly longer, it can effectively reduce the risk of postoperative stomy complications, especially in reducing the occurrence of postoperative stomy prolapse.