Abstract: The terminal ileostomy is an important surgical procedure for reducing the severity of anastomotic leakage (AL) and serious postoperative complications in rectal cancer surgery.The decision of terminal ileostomy is related to the subjective judgment of surgeons and the risk of AL,however,due to the lack of objective clinical guidelines,the decision of terminal ileostomy mainly relies on the surgeons’ experience.A large number of researches have developed or proposed some tools,such as scoring models,Nomogram,expert consensus,clinical guidelines,and artificial intelligence (AI) models,are dedicated to predicting postoperative AL or making reasonable decisions for the implementation of terminal ileostomy.Although some studies have shown favorable expected results,there is still a lack of highquality data validation.At present,the rational implementation of decisionmaking for terminal ileostomy is still being explored.It is believable that the personalized implementation of terminal ileostomy can be achieved in the near future with the development of new technologies for intraoperative anastomosis detection and the advancement of highquality clinical big data research.

Key words: Rectal cancer, Terminal ileostomy, Anastomotic leakage