To prevent
anastomotic leakage and other postoperative complications after laparoscopic
rectal cancer surgery, a protective
ileostomy is often used. However, the necessity of performing
ileostomy after laparoscopic
rectal cancer remains controversial. The aim of this meta-analysis was to assess the benefit of
ileostomy on
wound infection after laparoscopic
rectal cancer. The Cochrane Library, EMBASE, Web of Science, and PubMed were used to retrieve all related documents up to September 2023. Completion of the trial literature was submitted once the eligibility and exclusion criteria were met and the literature quality assessment was evaluated. This study compared the post-operative post-operative complications of an
ileostomy with that of non-
ileostomy in a
laparoscope. We used Reman 5.3 to analyse meta-data. Controlled studies were evaluated with ROBINS-I. The meta-analyses included 525 studies, and 5 publications were chosen to statistically analyse the data according to the classification criteria. There was no statistically significant difference in the rate of
postoperative wound infections among ostomate and nonostomate (odds ratio [OR], 1.79; 95% confidence interval [CI], 0.66, 4.84; p = 0.25). In 5 trials, the incidence of
anastomotic leak was increased after surgery in nonostomate patients (OR, 0.26; 95% CI, 0.12, 0.57; p = 0.0009). Two studies reported no significant difference in the length of operation time when nonstomal compared to stomal operations in patients with
rectal cancer (mean difference, 0.87; 95% CI, -2.99, 4.74; p = 0.66). No significant difference was found in the rate of
wound infection and operation time after operation among the two groups, but the incidence of anastomosis leak increased after operation. Protective
ileostomy after laparoscopic
rectal cancer was effective in reducing the risk of
anastomotic leakage in patients, and we found no additional risk of
infection. We cautiously conclude that protective
ileostomy is active and necessary for patients with a high risk of
anastomotic leakage after surgery, which needs to be further confirmed by high-quality studies with larger samples.