Curative Comparison Of The Modified Extraperitoneal With Intraperitoneal Colostomy In Laparoscopic Radical Resection

Objective:Our study is to explore the curative difference on the postoperative complication and bowel evacuation habit in laparoscopic radical resection with malignant tumor on the lower rectum or anal tube by using different colostomy route.Methods:In the retrospective study,57 Patients were enrolled who had laparoscopic radical resection due to the lower rectal or anal malignant tumor,including 26 patients with modified extraperitoneal laparocolostomy(observation group)and 31 Patients with traditional intraperitoneal laparocolostomy(control group).Difference of clinical characters,stomal complication and bowel evacuation habit after the operation were analyzed.Results:There were no significant difference in the incidence of gender,age,BMI,operation time,foodintake time,tumor Pathological stage and grade.On the complication of the stoma,10 days after the operation,the incidence of stomal edema and ischemia of observation group is higher than the control group(34.6%vs5.6% and 57.7%vs29%,P<0.05).6 month after the operation,the rate of stomal dermatitis of the observation group is lower(0%vs19.4%),which exists statistical significance.The incidence of parastomal hernia of observation group is lower than the control group after 24 months of the operation(7.7%vs32.3%,P<0.05).Refer to the comparison of the bowel evacuation habit,after 6 months of the operation,the feeling time and defecating frequency of the observation group is better than the control group(6.04±1.61 s vs 4.03±1.25s)and(5.46±1.17 times vs7.97±1.20times)with statistical significance.There still exists statistical significance in the defecating excitement,feeling time,defecating frequency and stool forming 12 months later.Conclusion:The laparoscopic extraperitoneal colostomy can relatively decrease the rate of stomal complication,and the patients of observation group have a better bowel evacuation habit.Therefore,the laparoscopic extraperitoneal colostomy should be recommended.