Linea alba support method of prophylactic loop ileostomy via lower abdominal midline incision for rectal cancer: a retrospective cohort study

Background: The traditional method of prophylactic loop ileostomy is time-consuming and prone to complications like stoma stenosis, peristomal adhesions, or dermatitis. The aim of this study is to evaluate the clinical application value and potential benefits of a novel approach named linea alba support method (LASM) of prophylactic loop ileostomy via lower abdominal midline incision.

Methods: The clinical data of rectal cancer patients admitted to the General Surgery Department of the First Affiliated Hospital of Xi'an Jiaotong University between January 2021 and December 2023 were retrospectively analyzed. The patients were divided into two groups based on different methods for prophylactic loop ileostomy they received, and clinical outcomes were further compared between the two groups.

Results: A total of 102 patients, including 48 patients underwent LASM (LASM group) and 54 patients underwent traditional method (TM group) were included in this study. The LASM group exhibited significantly shorter operative time (201.8 vs. 223.0 min, p = 0.011), ileostomy time (10 vs. 22 min, p < 0.001), the length of postoperative visual incision (5 vs. 8 cm, p < 0.001), and operative time of stoma closure (75 vs. 90 min, p < 0.001) compared to the TM group. There were no significant differences between the two groups in postoperative complications and stoma-related complications. In addition, LASM was an independent influencing factor for shorter operative time of ileostomy.

Conclusion: LASM of prophylactic loop ileostomy via lower abdominal midline incision, seamlessly integrating simplicity, safety, and exceptional cosmetic outcomes, merits extensive promotion and adoption.