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Clinical application of the B-type sutured ileostomy in robotic-assisted low anterior resection for rectal cancer: a propensity score matching analysis

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Abstract

Currently, there is no consensus on the position and method for temporary ileostomy in robotic-assisted low anterior resection for rectal cancer. Herein, this study introduced the B-type sutured ileostomy, a new temporary ileostomy technique, and compared it to the traditional one to assess its efficacy and safety. Between September 2020 and December 2022 in our centre, B-type sutured ileostomy was performed on 124 patients undergoing robotic-assisted low anterior resection for rectal cancer. A retrospective review of a prospectively collected database identified patients who underwent robotic-assisted low anterior resection for rectal cancer with a temporary ileostomy between January 2018 and December 2022. Patients who underwent B-type sutured ileostomy (B group) were matched in a 1:1 ratio with patients who underwent traditional ileostomy (Control group) using a propensity score based on age, sex, BMI, Comorbidity, American Society of Anesthesiologists (ASA) score, and Prior abdominal surgery history. Surgical and postoperative outcomes, health status, and stoma closure data were analyzed for both groups. ClinicalTrials.gov Identifier：NCT05915052.  The B group (n = 118) shows advantages compared to the Control group (n = 118) regarding total operation time (155.98 ± 21.63 min vs 168.92 ± 21.49 min, p = 0.001), postoperative body pain (81.92 ± 4.12 vs 78.41 ± 3.02, p = 0.001) and operation time of stoma closure (46.19 ± 11.30 min vs 57.88 ± 11.08 min, p = 0.025). The two groups had no other notable differences. The B-type sutured ileostomy is a safe and feasible option in robotic-assisted low anterior resection for rectal cancer. The B-type sutured ileostomy may offer advantages such as shorter overall surgical duration, lighter postoperative pain, and shorter second-stage ostomy incorporation surgery. However, attention should be directed towards the occurrence of stoma prolapse.

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Data availability

No datasets were generated or analysed during the current study.

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Funding

This study was financially supported by National Natural Science Foundation of China (No. 81972269) and 2023 Taizhou City Hailing District Science and Technology Development Plan (Social Development).

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Authors and Affiliations

  1. Clinical Medical College, Yangzhou University, Yangzhou, 225001, China

    Longhe Sun

  2. The Forth People’s Hospital of Taizhou, Taizhou, 225300, China

    Longhe Sun, Lili Ji & Chunhua Qian

  3. Northern Jiangsu People’s Hospital, Clinical Teaching Hospital of Medical School, Nan**g University, Yangzhou, 225001, China

    Jiajie Zhou, Shuai Zhao & Ruiqi Li

  4. Northern Jiangsu People’s Hospital, Yangzhou, 225001, China

    Wei Wang & Qi Zhang

  5. Clinical Medical College, Yangzhou University, Northern Jiangsu People’s Hospital, Yangzhou, 225001, China

    Daorong Wang

  6. Northern Jiangsu People’s Hospital, Yangzhou Institute of General Surgery, Yangzhou University, Yangzhou, 225001, China

    Daorong Wang

  7. Key Laboratory of Basic and Clinical Transformation of Digestive and Metabolic Disease, Yangzhou, China

    Daorong Wang

Authors
  1. Longhe Sun
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  2. Jiajie Zhou
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  3. Lili Ji
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  4. Wei Wang
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  5. Qi Zhang
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  6. Chunhua Qian
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  7. Shuai Zhao
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  8. Ruiqi Li
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  9. Daorong Wang
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Contributions

Longhe Sun designed the study, analyzed and interpreted the data, and drafted the manuscript. Wei Wang, Lili Ji, Qi Zhang, Chunhua Qian, Ruiqi Li and Shuai Zhao analyzed and interpreted the data. Jiajie Zhou and Daorong Wang concepted and designed the study and revised the manuscript. The authors read and approved the final manuscript.

Corresponding author

Correspondence to Daorong Wang.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval and consent to participate

The ethical committee of Northern Jiangsu People’s Hospital and The Forth People’s Hospital of TaiZhou approved this study. Informed consent was obtained from each patient before the surgical procedure.

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Not applicable.

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Sun, L., Zhou, J., Ji, L. et al. Clinical application of the B-type sutured ileostomy in robotic-assisted low anterior resection for rectal cancer: a propensity score matching analysis. J Robotic Surg 18, 159 (2024). https://doi.org/10.1007/s11701-024-01924-8

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