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This study aimed to explore the factors affecting the selection of diverting ileostomy (DI) following laparoscopic low anterior resection for rectal cancer.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This retrospective, case-control study included patients who underwent laparoscopic-assisted sphincter-saving surgery for mid-low rectal cancer from January 2019 to June 2021. Univariate and multivariate analyses were performed on the patient\u2019s clinicopathological characteristics and pelvic dimensions measured by abdominopelvic electron beam computed tomography.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 382 patients were included in the analysis, of which 182 patients (47.6%) did not undergo DI, and 200 patients (52.4%) underwent DI. The univariate analysis suggested that male sex (<jats:italic>p<\/jats:italic>\u2009=\u20090.003), preoperative radiotherapy (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), patients with an anastomosis below the levator ani plane (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), the intertuberous distance (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), the sacrococcygeal distance (<jats:italic>p<\/jats:italic>\u2009=\u20090.025), the mid pelvis anteroposterior diameter (<jats:italic>p<\/jats:italic>\u2009=\u20090.009), and the interspinous distance (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) were associated with performing DI. Multivariate analysis confirmed that preoperative radiotherapy (<jats:italic>p<\/jats:italic>\u2009=\u20090.037, odds ratio [OR]\u2009=\u20092.98, 95% confidence interval [CI]\u2009=\u20091.07\u20138.30), anastomosis below the levator ani plane (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, OR\u2009=\u20097.09, 95% CI\u2009=\u20094.13\u201312.18), and the interspinous distance (<jats:italic>p<\/jats:italic>\u2009=\u20090.047, OR\u2009=\u20090.97, 95% CI\u2009=\u20090.93-1.00) were independently associated with performing DI.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Pelvic parameters also influence the choice of DI. According to this single-center experience, patients with a shorter interspinous distance, particularly narrow pelvic with an interspinous distance of &lt;\u200994.8\u00a0mm, preoperative radiotherapy, and anastomosis below the levator ani plane, prefer to have a DI and should be adequately prepared by the physician.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12893-024-02316-3","type":"journal-article","created":{"date-parts":[[2024,1,23]],"date-time":"2024-01-23T06:01:44Z","timestamp":1705989704000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["What affects the selection of diverting ileostomy in rectal cancer surgery: a single-center retrospective study"],"prefix":"10.1186","volume":"24","author":[{"given":"Zhen","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuchen","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinquan","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,1,23]]},"reference":[{"key":"2316_CR1","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1007\/s11605-009-1067-4","volume":"14","author":"T Akasu","year":"2010","unstructured":"Akasu T, Takawa M, Moriya Y, et al. 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