’Comparative Study - Dumpling suture method versus traditional suture method of protective loop ileostomy - retrospective comparative cohort study

Sep 22, 2026

Diverting loop ileostomy (DLI) in laparoscopic anterior rectal resection (LAR) is routinely used to reduce complications from anastomotic leakage in patients at high risk of anastomotic fistula, yet specimen extraction through stoma incision (EXSI) can lead to enlarged incisions and higher stomal complications. This retrospective comparative cohort study evaluated a dumpling suture method (DSM) using skin-folding sutures versus a traditional suture method (TSM). DSM significantly reduced stomal complications and improved discoloration, erosion, tissue overgrowth, stomal pain, and quality of life outcomes.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Background

Materials and Methods

Results

Comparative outcomes between DSM and TSM

Conclusion

Introduction

Anastomotic fistula risk and role of DLI

EXSI incision enlargement and complications

’Comparative Study-Retrospective Cohort ‘Dumpling suture method’ versus traditional suture method of protective loop ileostomy in laparoscopic anterior rectal resection with specimen extraction through stoma incision: a retrospective comparative cohort study Jiani Gu, MSN, Jin Wang, MD, Xingwang Hu, MD, Wenjun Ding, MD, Long Cui, PhD MD, Peng Du, PhD MD, Zhonglin Liang, PhD MD*, Tingyu Wu, PhD, MD* Background: A diverting loop ileostomy (DLI) is performed in laparoscopic anterior rectal resection (LAR) surgery at high risk of anastomotic ﬁstula. Minimally invasive surgery promotes postoperative recovery and cosmetics. To reduce abdominal trauma, specimen extraction through stoma incision (EXSI) is usually performed to avoid auxiliary abdominal incision with enlarged stomal incision. The traditional suture method (TSM) reduces the incision size by suturing the ends of the enlarged incision, leading toperistomal incisions and a higher risk of stomal complications. The study aimed to introduce the dumpling suture method (DSM) of PLI and compare this new method with TSM. Materials and Methods: The authors propose a novel stoma suture technique, which utilized a method of skin folding suture to reduce the enlarged incision size. A retrospective analysis was conducted on 71 consecutive patients with rectal cancer who underwent LAR-DLI with EXSI, and the intraoperative details and postoperative outcomes of the two groups were measured. Results: The DSM group showed a lower stomal complication rate (10 .3 vs. 35.7%, P = 0.016) than that of the TSM group. The scores of DET (Discoloration, Erosion, Tissue overgrowth), stomal pain, quality of life were all signiﬁcantly lower in DSM group than in TSM group. In multivariate analysis, DSM was an independent protective factor for stoma-related complications. Operative time, time to ﬁrst ﬂatus, defecation and eat, nonstomal related postoperative complications were similar in both groups. Conclusion: DSM utilizes a method of skin folding suture to reduce the enlarged incision size, which is safe and effective in reducing the incidence of peristomal skin infections and stomal complications. This procedure offers a novel suturing approach for loop ileostomy with enlarged incision, effectively reducing the postoperative trauma and incidence of stomal complications. Keywords: diverting loop ileostomy, dumpling suture method, laparoscopic anterior rectal resection, rectal cancer, stoma-related complication Introduction In rectal cancer surgery, particularly in patients with low rectal cancer, the incidence of anastomotic ﬁstula ranges from 9.8 to 37.5% in laparoscopic anterior rectal resection (LAR), which represents a signiﬁcant postoperative concern and often requires a secondary operation[1–4] . Therefore, in patients at high risk for anastomotic ﬁstula, diverting loop ileostomy (DLI) to divert fecal ﬂow is routinely performed, which can protect the anastomosis and reduce the complications caused by postoperative anastomotic leakage[5] . In LAR-DLI, an auxiliary abdominal incision typically measuring 5–10 cm in length is usually made for specimen extraction. Recent decades have witnessed technological advancementsand innovations in colorectal surgery. These developments have not only resulted in a decrease in abdominal surgical incisions, but have also eliminated the need for additional specimen extraction sites. For patients who require a DLI in LAR surgery, Department of Colorectal and Anal Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China Jiani Gu and Jin Wang contributed equally to this manuscript. Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. *Corresponding author. Address: 1665 Kongjiang Road, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, People’s Republic of China, and Tel.:/fax: +860 232 507 [7855. E

FAQs

What clinical problem does the study address in laparoscopic anterior rectal resection?

The study targets the risk of anastomotic fistula and the stomal complications associated with specimen extraction through stoma incision (EXSI) using an enlarged incision.

How does the dumpling suture method (DSM) differ from the traditional suture method (TSM)?

DSM reduces the enlarged incision size by using a skin-folding suture technique, whereas TSM reduces the incision size by suturing the ends of the enlarged incision.

What were the main outcome findings comparing DSM with TSM?

DSM showed a lower stomal complication rate (10.3% vs. 35.7%, P=0.016) and significantly lower scores for discoloration, erosion, tissue overgrowth, stomal pain, and quality of life. Multivariate analysis indicated DSM was an independent protective factor.

Sep 22, 2026

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