Chimney Trial of Parastomal Hernia Prevention

Inclusion Criteria: * 18 years or older * Rectal adenocarcinoma with curative intent laparoscopic or robotic assisted abdominoperineal resection or low Hartmann´s operation and permanent colostomy * Patient has a life expectancy of at least 12 months. * Patient must sign Informed consent before any study procedures and agrees to attend all study visits Exclusion Criteria: * Abdominoperineal resection or Hartmann's operation by laparotomy or conversion to laparotomy * Complication requiring laparotomy during post surgery treatment at surgical ward after APR * Patient with a comorbid illness or condition that would preclude the use of surgery (ASA 4-5). * Patients with concurrent or previous malignant tumors within 5 years before study enrollment * Patients with T4b tumors which impose a multi-organ resection * Rectal malignancy other than adenocarcinoma * Patient undergoing emergency procedures * Planned rectal surgery along with major concomitant procedures (e.g. hepatectomies, other intestinal resections). * Metastatic disease with no possibility of curative surgery * Pregnant or suspected pregnancy * Patients living geographically distant and/or unwilling to return for follow-ups or comply with all study requirements * Active abdominal infection at the time of surgery * Previous surgery at the colostomy site * Language barrier or other reasons why informed consent is not possible