{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T14:39:38Z","timestamp":1767796778496,"version":"3.49.0"},"reference-count":27,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T00:00:00Z","timestamp":1764633600000},"content-version":"unspecified","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,11,13]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Colorectal cancer (CRC) incidence is increasing, and treating low rectal cancer poses challenges in balancing oncological control with functional preservation. While preoperative chemoradiotherapy (CRT) improves sphincter preservation, anastomotic leakage (AL) remains a major complication. This trial aims to compare the efficacy of modified pull-through procedure versus coloanal anastomosis (CAA) with temporary stoma in low rectal cancer patients following preoperative CRT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This is a multicentre, assessor-blinded, randomised controlled trial. A total of 216 patients with low rectal cancer (\u22647\u2009cm from the anal verge) after preoperative CRT will be enrolled and randomly assigned (1:1) to undergo either the modified pull-through procedure or CAA with temporary stoma. The primary outcome is the incidence of AL within 1\u2009month. Secondary outcomes include complications (Clavien-Dindo classification), length of hospital stay, anorectal function (LARS score (Low Anterior Resection Syndrome Score)), and quality of life (EQ-5D questionnaire (EuroQol five dimensions questionnaire)). Patients will be followed for 36 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The study has obtained ethics approval from the Biomedical Ethics Committee of West China Hospital, Sichuan University (ethics approval ID: 2025-Review-(144)). All centres have obtained local institutional review board approval. Results will be disseminated via academic conferences and peer-reviewed journals to optimise clinical practice for low rectal cancer surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>ChiCTR2500100246.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-107385","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T18:21:27Z","timestamp":1764786087000},"page":"e107385","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Modified pull-through procedure versus coloanal anastomosis with temporary stoma for low\/ultra-low rectal cancer following preoperative chemoradiotherapy: protocol for a multicentre randomised controlled 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China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mingtian","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Colorectal Cancer Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xvyang","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Colorectal Cancer Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6530-3104","authenticated-orcid":false,"given":"Mingjun","family":"Huang","sequence":"additional","affiliation":[{"name":"Day Surgery Center, West China School of Nursing, West China Hospital of Sichuan University, Chengdu, Sichuan, 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