Abstract: Controversy and consensus on protective stoma for rectal cancer surgery        XIE Zhong-shi. Department of Gastrointestinal and Colorectal Surgery, China-Japan Union Hospital of Jilin University, Changchun 130033, China
Abstract    Since total mesorectal excision（TME）was proposed，it has been widely used in clinical practice and has become the gold standard for rectal cancer surgery.With the intervention of surgical technology，modern medical equipment，high-definition laparoscopy and robots，different surgical methods have been derived，including transanal total mesorectal excision，etc.Although the quality of the surgery has been repeatedly emphasized，the reconstruction of the digestive tract after the resection of the specimen still confounds the surgeon.Anastomotic leakage is an unavoidable problem and is one of the most serious complications after rectal cancer surgery.For this reason，a protective stoma is often performed clinically.However，there are still many controversies about protective stoma.For example，the indication，meaning and timing of protective stoma can really prevent anastomosis?Does it affect the function of the anus after being repaid?And some technical differences，such as the choice of stoma style，method of acceptance，and so on.

Key words: rectal cancer, protective stoma, anastomotic leakage

摘要： 全直肠系膜切除（TME）自提出以来，便成为直肠癌手术的金标准。随着设备与技术的发展，由TME衍生出了许多不同的术式，TME的质量也在不断的提高。但对于外科医生来说，仍不能完全杜绝吻合口漏的发生。吻合口漏是直肠癌术后最严重的并发症之一，严重者甚至可能危及生命。为此，一些学者提出保护性造口，以降低吻合口漏的发生率或减轻吻合口漏引起的相关临床症状。但目前保护性造口尚存在许多争议，如保护性造口的指征、意义及还纳时机，是否真正能够预防吻合口漏的发生；还纳后是否影响肛门的功能；以及一些技术方面的差异，诸如造口方式的选择、还纳的方法等。

关键词: 直肠癌, 保护性造口, 吻合口漏