A Study Of Extraperitoneal Colostomy In Laparoscopic Abdominoperineal Resection For Low Rectal Cancer

Objective: This study is a retrospective analysis to evaluate the advantages of laparoscopic extraperitoneal colostomy after laparoscopic abdominoperineal resection and the complications of stoma.Method: Fifty patients with low rectal cancer or anal cancer undergoing laparoscopic abdominoperineal resection from April 2013 to July 2016 were enrolled in this study and randomly divided into extraperitoneal colostomy group intraperitoneal colostomy group. The stoma-related complications were recorded, also the time of return of bowl function and defecation function.Results: Compared with the intraperitoneal colostomy group,the surgery time was longer in extraperitoneal colostomy group[(21.3±1.8)min VS(18.2±1.6)min], while the difference was not statistically significant(P=0.052). The average return time of bowel function was 2.6±0.8 days and had an average of 3.1±0.8 days for defecation. All patients were followed up ranges 1–25 months. Only 1 case of 22 patients(1/22) occured the parastomal hernia, the rest of patients had no stoma-related complications happened. Only2 cases had a bad contoral of the defecation. Twenty of them got a special feeling about defecation and better defecation fucntion. While,28 patients undergoing laparoscopic intraperitoneal colostomy were followed up ranges 2-36 months, 5 cases occured the parastomal hernia and have 5 isolations of stoma mucosa. The average return time of bowel function was 3.0±0.8 days and had an average of 3.4±0.7 days for defecation. Half of the patients with intraperitoneal colostomy got a bad contoral of the defecation.Conclusion: Compared with the traditional intraperitoneal route the laparoscopic extraperitoneal colostomy can effectively reduce the stoma-related complications. The extraperitoneal route can also accelerate the time of bowel function recovery.Patients have a special feeling about defecation and better defecation fucntion.