How to avoid a stoma?
Tuesday, 1 December 2026, 4:50 pm
Jérémie Lefevre
Jérémie Lefevre contends that routine prophylactic diverting stomas after low anterior resection unnecessarily subject most patients to stoma-related complications, since only a fraction will suffer an anastomotic leak. He therefore recommends a strategy of deferred diversion using a temporary endoluminal bypass sheath for the first 10 postoperative days to protect the anastomosis while avoiding stoma formation in patients who heal uneventfully. This approach aims to retain the safety of diversion for true high-risk cases while markedly reducing the overall rate of stomas and their associated morbidity, costs, and second operations.
About Jérémie Lefevre
Jérémie Lefevre is Professor of Digestive Surgery at Sorbonne University and head of colorectal surgery at Saint-Antoine Hospital in Paris, where he specializes in complex colorectal cancer, hereditary syndromes, inflammatory bowel disease, and anastomotic complications. As a leading investigator in the GRECCAR group and principal investigator of international trials such as SAFE‑3, he has published more than 280 peer‑reviewed articles and serves as General Secretary of the French Society of Digestive Surgery.
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