The Application Of Extraperitoneal Oblique Tunnel Sigmoidostomy In Laparoscopic Miles Operation

Objective Peritoneal external oblique tunnel sigmoid colostomy joint rectal resection of clinical value in laparoscopic abdominal perineal.Matterials and MethodsFrom January 2015 to December 2017,select the clinical case data of 104 patients with low rectal cancer who assisted laparoscopic-assisted combined lower abdominal perineal combined rectal resection(Miles).from January 2015 to December 2017 at the First Affiliated Hospital of Bengbu Medical College,gastrointestinal surgery residency deadline assited laparoscopic abdominal perineal resection of the rectum(Miles)of 104 the clinical cases date of low rectal carcinoma.In the observation group,52 cases assisted extraperitoneal oblique tunnel sigmoid colostomy,and the rest underwent intraperitoneal sigmoid colostomy.Follow-up for 24-60 months,statistics postoperative hospital stay and the time of first exhaust and defecation,short-term stoma-complications(separation,edema,ischemia or necrosis,stoma intestinal tube)Rupture,obstruction),long-term complications of the stoma(retraction,stenosis,para-hernia,prolapse),and defecation feeling in the 6th month after surgery.ResultsObservation group’s first vent time after stoma [(3.308±0.422)d],first defecation time[(4.183±0.552)d],control group [(3.043±0.296)d],[(3.933±0.420)d].2 groups was statistically significant(P<0.05);Postoperative hospital stay group[(11.961±1.620)d],the control group [(11.635±2.318)d] 2 groups no significant difference(P>0.05).Observation group of short-term complications [15.385%(8/52)],control group [17.308%(9/52)],no significant difference between the 2 groups(P>0.05).Observation group for long-term complications [5.769%(3/52)],control group [32.692%(17/52)];Observation rate of bowel sensation in the 6th month after operation [86.538%(45/52)],the control group [40.385%(21/52)],2 includes a group statistical difference P<0.05).ConclusionsLow use of patients assiting laparoscopic colorectal cancer surgery Miles extraperitoneal sigmoid colostomy oblique tunnel is safe and feasible,and can significantly reduce postoperative stoma long-term morbidity,and patients have increased defecation rate.