To investigate the effect of prophylactic stoma on anastomotic fistula and low anterior resection syndrome (LARS) in patients with anterior resection for rectal cancer.

Clinical data of 245 cases with middle and low rectal cancer undergoing laparoscopic anterior resection for rectal cancer from December 2018 to December 2020 were collected. According to whether prophylactic ileostomy was performed, the patients were divided into two groups: routine group (161 cases) and stoma group (84 cases). The detection rate of anastomotic fistula, rate of secondary operation, length and costs of hospitalization, and score of LARS at 3-, 6-, 12-month after operation were compared between the two groups.

The rate of anastomotic fistula in the stoma group was significantly lower than that in the routine group (3.57% vs 12.42%, χ²=5.084, P=0.024). There were no significant differences in the rate of secondary operation (0 vs 2.48%), length of hospitalization [(8.42±0.86) d vs (8.68±1.15) d] and average costs of hospitalization [(5.42±0.36)×10⁴ yuan vs (5.54±0.89)×10⁴ yuan] between the two groups. The score of LARS in the stoma group was significantly lower than that in the routine group at postoperatively 3-month [(25.5±2.4) vs (34.3±4.1), t=18.109, P<0.001] and 6-month [(20.5±2.3) vs (28.8±2.7), t=23.991, P<0.001], but there was no significant difference between the two groups at 12-month postoperatively [(18.5±1.5) vs (18.9±1.8), t=1.745, P=0.082] .

Prophylactic stoma in anterior rectal resection can improve LARS score and reduce the probability of anastomotic fistula in patients with middle and low rectal cancer in the short term, but patients can not have long-term benefit, which can be carried out selectively in clinic.