Postoperative Effects of Different Enterostomy Approaches

Inclusion Criteria:

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

Exclusion Criteria:

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