The Safety and Efficiency of Stent-based Diverting Technique Versus Ileostomy in Rectal Cancer Patients

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• History of previous rectectomy, except endoscopic mucosal resection or endoscopic submucosal dissection.

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• Familial Adenomatosis Polyposis Coli (FAP), Hereditary Non-Polyposis Colorectal Cancer (HNPCC), active Crohn's disease or active colitis ulcerosa.
• History of unstable angina, myocardial infarction, cerebrovascular accident within the past six months.
• Groups who are particularly vulnerable include those who suffer from mental disease, cognitive impairment, severe illness, adolescents, illiterates, women during pregnancy or breast-feeding, etc.
• Patients with severe complications who do not tolerate surgery or need emergency surgery due to complication (bleeding, obstruction or perforation)
• Unable ot radical resection, or underwent Miles or Hartmann or TaTME procedure, or requirement of simultaneous surgery for other disease (except the gallblader or appendix due to benign lesion).

• Rectal adenocarcinoma confirmed pathologically.
• Rectal cancer patients with high-risk of anastomotic leakage(AL).
• Age from over 18 to under 80 years.
• Performance status of 0/1 on ECOG (Eastern Cooperative Oncology Group) scale.
• ASA (American Society of Anesthesiology) score class I, II, or III.
• Written informed consent.
  • Definition of high-risk of AL (one of them):
• Preoperative body mass index (BMI) ≥30 kg/m2;
• Long-term use of glucocorticoids before surgery (≥2 weeks);
• Poor general condition: Preoperative serum albumin was less than 30.0g/L after supportive treatment; or Preoperative renal replacement therapy (blood purification/hemodialysis) is required; or diabetes;
• Preoperative neoadjuvant radiotherapy;
• Distance between tumor and anal anus (baseline MRI) ≤7cm
• The number of stapler used to cut the rectum during the operation ≥3; or the defect of anastomosis is observed; or Intraoperative leak test was positive.