{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T02:31:25Z","timestamp":1786674685891,"version":"build-2736575974"},"reference-count":19,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Specimen\u2010extraction\u2010site (SES) loop ileostomy has been used to avoid an additional abdominal incision after laparoscopic low anterior resection. However, the optimal technique for constructing this type of ileostomy remains uncertain. This study aimed to compare two SES loop ileostomy construction strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed 419 patients with rectal cancer who underwent laparoscopic low anterior resection with SES loop ileostomy between 2018 and 2021. Patients were categorized according to the ileostomy construction strategy: nonsuturing of the peritoneum\u2013rectus sheath with routine support\u2010rod placement (Group A,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009256) or peritoneum\u2013rectus sheath suturing without support\u2010rod placement (Group B,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009163). Baseline characteristics, operative outcomes, stoma\u2010related complications, parastomal hernia, and reversal outcomes were compared.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline characteristics were comparable between groups. Ileostomy construction was faster in Group A than in Group B (14.2\u2009\u00b1\u20095.3 vs. 22.6\u2009\u00b1\u20098.2\u2009min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Overall stoma\u2010related complications and reversal outcomes were similar between groups. In the overall cohort, no significant differences were observed in overall, symptomatic, or asymptomatic CT\u2010detected parastomal hernia. In subgroup analysis, Stage III patients in Group A had a higher rate of symptomatic parastomal hernia than those in Group B, whereas overall and asymptomatic CT\u2010detected parastomal hernia did not differ significantly.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The two SES loop ileostomy construction strategies showed broadly comparable overall stoma\u2010related and reversal outcomes. Among Stage III patients, however, the nonsuturing strategy with support\u2010rod placement was associated with a higher rate of symptomatic parastomal hernia. Given the retrospective design, the subgroup nature of this finding, and the difference in support\u2010rod use between groups, the results should be interpreted cautiously.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.70869","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T01:51:24Z","timestamp":1786672284000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of Two Specimen\u2010Extraction\u2010Site Loop Ileostomy Construction Strategies After Laparoscopic Low Anterior Resection: A Retrospective Study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8289-8561","authenticated-orcid":false,"given":"Qing","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Operating Room Qilu Hospital of Shandong University  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of General Surgery Qilu Hospital of Shandong University  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaole","family":"hu","sequence":"additional","affiliation":[{"name":"Department of Operating Room Qilu Hospital of Shandong University  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"issue":"2","key":"e_1_2_7_2_1","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1016\/j.jss.2014.08.012","article-title":"Outcome of Laparoscopic Versus Open Resection for Rectal Cancer in Elderly Patients","volume":"193","author":"Zeng W. G.","year":"2015","journal-title":"Journal of Surgical Research"},{"issue":"2","key":"e_1_2_7_3_1","first-page":"115","article-title":"Cancer Statistics in China, 2015","volume":"66","author":"Chen W.","year":"2016","journal-title":"CA: A Cancer Journal for Clinicians"},{"key":"e_1_2_7_4_1","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1186\/s40880-016-0097-z","article-title":"Effect of Preoperative Injection of Carbon Nanoparticle Suspension on the Outcomes of Selected Patients With Mid\u2010Low Rectal Cancer","volume":"35","author":"Zhang X. M.","year":"2016","journal-title":"Chinese Journal of Cancer"},{"issue":"4","key":"e_1_2_7_5_1","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1097\/SLA.0b013e31827b8ed9","article-title":"Multicenter Analysis of Risk Factors for Anastomotic Leakage After Laparoscopic Rectal Cancer Excision: The Korean Laparoscopic Colorectal Surgery Study Group","volume":"257","author":"Park J. 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Y.","year":"2005","journal-title":"Diseases of the Colon and Rectum"},{"issue":"2","key":"e_1_2_7_7_1","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1097\/SLA.0b013e3180603024","article-title":"Defunctioning Stoma Reduces Symptomatic Anastomotic Leakage After Low Anterior Resection of the Rectum for Cancer: A Randomized Multicenter Trial","volume":"246","author":"Matthiessen P.","year":"2007","journal-title":"Annals of Surgery"},{"issue":"2","key":"e_1_2_7_8_1","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1002\/bjs.4806","article-title":"Risk Factors for Anastomotic Failure After Total Mesorectal Excision of Rectal Cancer","volume":"92","author":"Peeters K. C.","year":"2005","journal-title":"British Journal of Surgery"},{"issue":"11","key":"e_1_2_7_9_1","doi-asserted-by":"crossref","first-page":"1258","DOI":"10.1097\/DCR.0000000000001202","article-title":"Different Risk Factors for Early and Late Colorectal Anastomotic Leakage in a Nationwide Audit","volume":"61","author":"Sparreboom C. L.","year":"2018","journal-title":"Diseases of the Colon and Rectum"},{"issue":"1","key":"e_1_2_7_10_1","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1186\/s12893-023-02129-w","article-title":"Complications of Preventive Loop Ileostomy Versus Colostomy: A Meta\u2010Analysis, Trial Sequential Analysis, and Systematic Review","volume":"23","author":"Ge Z.","year":"2023","journal-title":"BMC Surgery"},{"issue":"1","key":"e_1_2_7_11_1","doi-asserted-by":"crossref","first-page":"2316","DOI":"10.1038\/s41598-019-38790-6","article-title":"Safety of Temporary Ileostomy via Specimen Extraction Site in Rectal Cancer Patients Who Underwent Laparoscopic Low Anterior Resection","volume":"9","author":"Lee K. Y.","year":"2019","journal-title":"Scientific Reports"},{"issue":"5","key":"e_1_2_7_12_1","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1089\/lap.2014.0545","article-title":"Specimen Extraction From the Defunctioning Ileostomy Site or Pfannenstiel Incision During Total Laparoscopic Low Anterior Resection for Rectal Cancer","volume":"25","author":"Karakayali F. Y.","year":"2015","journal-title":"Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A"},{"key":"e_1_2_7_13_1","doi-asserted-by":"crossref","first-page":"1116502","DOI":"10.3389\/fonc.2023.1116502","article-title":"Which Site Is Better for Prophylactic Ileostomy After Laparoscopic Rectal Cancer Surgery? By the Specimen Extraction Site or New Site: A Systematic Review and Meta\u2010Analysis","volume":"13","author":"Zheng B.","year":"2023","journal-title":"Frontiers in Oncology"},{"issue":"29","key":"e_1_2_7_14_1","doi-asserted-by":"crossref","first-page":"4571","DOI":"10.3748\/wjg.v29.i29.4571","article-title":"Comparison of Modified Gunsight Suture Technique and Traditional Interrupted Suture in Enterostomy Closure","volume":"29","author":"Chen C.","year":"2023","journal-title":"World Journal of Gastroenterology"},{"issue":"1","key":"e_1_2_7_15_1","doi-asserted-by":"crossref","first-page":"104","DOI":"10.3748\/wjg.v24.i1.104","article-title":"Surgical Specimen Extraction via a Prophylactic Ileostomy Procedure: A Minimally Invasive Technique for Laparoscopic Rectal Cancer Surgery","volume":"24","author":"Wang P.","year":"2018","journal-title":"World Journal of Gastroenterology"},{"issue":"10","key":"e_1_2_7_16_1","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1097\/DCR.0000000000002498","article-title":"The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for Ostomy Surgery","volume":"65","author":"Davis B. R.","year":"2022","journal-title":"Diseases of the Colon and Rectum"},{"issue":"1","key":"e_1_2_7_17_1","doi-asserted-by":"crossref","first-page":"9101","DOI":"10.1038\/s41598-021-88674-x","article-title":"Comparison of the Clinical Outcomes of Skin Bridge Loop Ileostomy and Traditional Loop Ileostomy in Patients With Low Rectal Cancer","volume":"11","author":"Ye H.","year":"2021","journal-title":"Scientific Reports"},{"issue":"1","key":"e_1_2_7_18_1","doi-asserted-by":"crossref","first-page":"44","DOI":"10.3393\/ac.2020.08.03","article-title":"The Relationship Between High\u2010Output Stomas, Postoperative Ileus, and Readmission After Rectal Cancer Surgery With Diverting Ileostomy","volume":"37","author":"Lee N.","year":"2021","journal-title":"Annals of Coloproctology"},{"issue":"2","key":"e_1_2_7_19_1","doi-asserted-by":"crossref","first-page":"e044692","DOI":"10.1136\/bmjopen-2020-044692","article-title":"Prospective, Randomised, Multicentre, Open\u2010Label Trial, Designed to Evaluate the Best Timing of Closure of the Temporary Ileostomy (Early Versus Late) in Patients Who Underwent Rectal Cancer Resection and With Indication for Adjuvant Chemotherapy: The STOMAD (STOMa Closure Before or After Adjuvant Therapy) Randomised Controlled Trial","volume":"11","author":"Massucco P.","year":"2021","journal-title":"BMJ Open"},{"issue":"1","key":"e_1_2_7_20_1","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1097\/DCR.0000000000001839","article-title":"Early Versus Late Preventive Ileostomy Closure Following Colorectal Surgery: Systematic Review and Meta\u2010Analysis With Trial Sequential Analysis of Randomized Controlled Trials","volume":"64","author":"Cheng Z.","year":"2021","journal-title":"Diseases of the Colon and Rectum"}],"container-title":["ANZ Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.70869","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ans.70869","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.70869","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T01:51:33Z","timestamp":1786672293000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ans.70869"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,13]]},"references-count":19,"alternative-id":["10.1111\/ans.70869"],"URL":"https:\/\/doi.org\/10.1111\/ans.70869","archive":["Portico"],"relation":{},"ISSN":["1445-1433","1445-2197"],"issn-type":[{"value":"1445-1433","type":"print"},{"value":"1445-2197","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,13]]},"assertion":[{"value":"2025-10-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ans.70869"}}