title: [Necessity of defunctioning stoma in low anterior resection for rectal cancer: a meta-analysis].
abstract: OBJECTIVE
  To evaluate the necessity of defunctioning stoma in low anterior resection for rectal cancer below peritoneal reflection.
  
  
  METHODS
  The databases of Medline, Embase, Cochrane Library, Wanfang and CNKI were searched. The eligible studies were identified for pooled analyses.
  
  
  RESULTS
  Six randomized controlled trials with 648 cases(332 patients with defunctioning stoma and 316 without stoma) and 25 retrospective controlled trials with 10,722 cases(4,470 patients with defunctioning stoma and 6,252 without stoma) were included. Combined analyses showed that defunctioning stoma was effective for decreasing risk of postoperative anastomotic leakage (RR=0.33 and 95% CI:0.21-0.53 for RCTs, OR=0.60 and 95% CI:0.42-0.85 for retrospective studies), reoperation (RR=0.30, 95% CI:0.16-0.53 for RCTs, OR=0.26 and 95% CI:0.21-0.32 for retrospective studies) and mortality(OR=0.41, 95% CI:0.27-0.62 for retrospective studies).
  
  
  CONCLUSIONS
  Defunctioning stoma should be routinely performed in low anterior resection for high-risk patients.
authors.affiliation: Department of General Surgery, Southern Medical University, Guangxi Liuzhou, China. sunyi1166@sina.com
authors.forename: Yi
authors.initials: Y
authors.lastname: Sun
authors.forename: Hong-jie
authors.initials: HJ
authors.lastname: Yang
authors.forename: Yong-gang
authors.initials: YG
authors.lastname: Lu
authors.forename: Tian-wei
authors.initials: TW
authors.lastname: Liang
mesh_terms: D057868:Anastomotic Leak / Q000209:etiology / Q000517:prevention & control; D004766:Enterostomy / Q000379:methods*; D006801:Humans; D011183:Postoperative Complications / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic; D012004:Rectal Neoplasms / Q000601:surgery*