Trial Evaluating the Tailored Versus the Systematic Use of Defunctioning Stoma After Total Mesorectal Excision for Rectal Cancer (GRECCAR17)

Inclusion Criteria:

* Age 18-80 years;
* Rectal adenocarcinoma (histologically proven)
* No metastasis or medical history of colorectal metastasis (M0)
* Patients with rectal cancer \< 12 cm from the anal verge (determined by rectal examination or MRI)
* Patients operated on by mini-invasive TME (laparoscopic, robotic or TaTME);
* With or without neo adjuvant treatment
* Realize a stapling anastomosis \< 7 cm from the anal verge (determined by rectal examination or MRI)
* Patients with expected defunctioning ileostomy
* Appropriate hematologic function: hemoglobin ≥ 10.5 g/dL, leukocytes \> 4000/mm3, blood platelets \> 100,000/mm3);
* Appropriate renal function (serum creatinine \< 15 mg/dL);
* Effective contraception of childbearing age : Male patients and premenopausal women should agree to use two medically validated contraceptive methods (one for the patient et one for the partner) during the study
* Patient affiliated or beneficiary to a health security system;
* Patient and doctor have signed informed consent

Exclusion Criteria:

* Patients with rectal cancer requiring TME surgery with handsewn anastomosis;
* Patients operated on by open approach;
* Previous pelvic irradiation for reasons other than rectal cancer
* Concomitant cancer or medical history of cancer within 5 years other than cancers treated in situ (cervical carcinoma or basocellular carcinoma or spinocellular carcinoma)
* Patients with expected defunctioning colostomy;
* Patients with perforated rectal cancer or preoperative pelvic sepsis;
* Patients with inflammatory bowel disease and/or bowel obstruction,
* Patients operated on in emergency;
* Patients with poor nutrition (Albumin \< 34 g/L, pre-Alb \< 0.14 g/L)
* Patients with extended-TME or pelvic exenteration (prostate);
* Patients with history of heart or vascular ischemia;
* Severe heart disease or congestive heart disease;
* Patients with immunodeficiency and/or under corticotherapy;
* Severe lung disease or respiratory failure;
* Severe kidney disease;
* Previous disease or disability expected to influence the assessment of postoperative QOL;
* Pregnancy or breast feeding;
* Persons deprived of liberty or under guardianship (curatorship or tutorship) or incapable of giving consent;
* Any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol or follow-up scheduled.