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

Inclusion Criteria:

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

Exclusion Criteria:

1. History of previous rectectomy, except endoscopic mucosal resection or endoscopicsubmucosal dissection.
2. Familial Adenomatosis Polyposis Coli (FAP), Hereditary Non-Polyposis Colorectal Cancer (HNPCC), active Crohn's disease or active colitis ulcerosa.
3. History of unstable angina, myocardial infarction, cerebrovascular accident within thepast six months.
4. Groups who are particularly vulnerable include those who suffer from mental disease,cognitive impairment, severe illness, adolescents, illiterates, women during pregnancyor breast-feeding, etc.
5. Patients with severe complications who do not tolerate surgery or need emergencysurgery due to complication (bleeding, obstruction or perforation)
6. Unable ot radical resection, or underwent Miles or Hartmann or TaTME procedure, orrequirement of simultaneous surgery for other disease (except the gallblader orappendix due to benign lesion).