Abstract:Objective To investigate the effect of protective stoma on organ space infection (OSI) in patients with rectal cancer after low anterior rectal resection (Dixon operation). Methods Post-operative OSI of rectal cancer patients who underwent Dixon operation in a hospital from 2017 to 2021 was monitored prospectively, risk factors for infection were analyzed, according to the distance from tumor to anal margin, patients were divided into three groups: ≥7 cm, 5-7 cm and < 5 cm groups, proportion of protective stoma and infection of each group, as well as infection rates of patients with and without protective stoma were compared. Results From 2017 to 2021, OSI rate in rectal cancer patients undergoing Dixon operation was 4.79% (51/1 064). Risk factors analysis showed that male, pre-operative anemia, pre-operative intestinal obstruction, drainage time>10 days, distance from tumor to anus < 7 cm, operation duration >3 hours were independent risk factors for OSI, and protective stoma was the independent protective factor for OSI. Patients with the distance from tumor to anus ≥7 cm had the lowest post-operative infection rate (2.76%); patients with the distance of 5-7 cm had the highest post-operative infection rate (9.52%); patients with the distance < 5 cm had the highest proportion of protective stoma (72.05%). For patients with distance from tumor to anus ≥7 cm, protective stoma can not effectively prevent the occurrence of infection, while for patients whose distance was < 5 cm, protective stoma can significantly reduce the infection rate, difference was significant (P=0.02); infection rate of patients with 5-7 cm from tumor to anus after protective stoma also decreased significantly, but difference was not significant (P=0.07). Conclusion Protective stoma has protective effect on OSI in rectal cancer patients after Dixon operation, especially in patients whose distance from tumor to anus is less than 5 cm.