To compare the effects of single or double lumen prophylactic ileostomy on the incidence rate and outcome of diversion colitis after low anterior rectal resection due to rectal cancer.

From January 2015 to September 2019, 147 patients with low rectal cancer underwent laparoscopic anterior resection and prophylactic ileostomy in Tangdu Hospital of Air Force Military Medical University. According to the inclusion criteria, sixty-eight cases were divided into two groups according to the different ways of stoma: single lumen group (31 cases) and double lumen group (37 cases). We collected the basic clinical data of the two groups and the short-term results of the LAR+PI and the operation of ileostomy reversal. The endoscopic changes (edema, bleeding or contact bleeding) and the related clinical symptoms (serous/mucus/blood secretion, abdominal pain, tenesmus, diarrhea) 3~4 months later after the ostomy and 4~6 months later after the ileostomy reversal were collected.

The preoperative data of the two groups were comparable, except that the operation time of double lumen group was shorter than that of single lumen group (50.00±7.55 min vs. 63.22±6.26 min,t=7.768;P＜0.01). There was no statistical significance in the operation time, ileostomy reversal time, intraoperative bleeding volume, intestinal function recovery time, hospitalization time and recent postoperative complications of the two groups; The incidence rate of diversion colitis in the double lumen group was significantly lower than that in the single lumen group (54.1% vs. 80.6%, χ²=5.328; P＜0.05). There was a significant difference in severity of diversion colitis between the two groups (16.2% vs. 51.6%, χ²=9.656; P＜0.05). The incidence rate of diarrhea in the single lumen group was higher than that in the double lumen group (29.0% vs. 8.1%, χ²=5.082; P＜0.05).

Both single lumen and double lumen ileostomy are safe and feasible. Double lumen ileostomy may have more advantages in preventing the occurrence and improving the outcome of diversion colitis.