Comparison Of Clinical Efficacy Of Laparoscopic Extraperitoneal And Intraperitoneal Colostomy For Rectal Cancer

Objective: To investigate the differences in postoperative complications between extraperitoneal ostomy and traditional intraperitoneal ostomy for low rectal cancer.Methods: A retrospective analysis was performed on 149 cases of permanent sigmoid colostomy performed by LAPR in shengjing hospital from January 2015 to June 2018.Among them,there were 77 cases of laparoscopic extraperitoneal stoma in the observation group and 72 cases of laparoscopic intraperitoneal stoma in the control group.Both groups underwent laparoscopic surgery.The difference of time,blood loss,postoperative complications and near and long term defecation habits between the two groups were compared.Results: There was no significant statistical significance in age,sex,BMI,ostomy bleeding,tumor stage and pathological type between the two groups.The ostomy time of the observation group was 21.18±2.39 minutes(vs18.10±2.05 minutes),and there was a significant statistical difference between the two groups.In this study,there was no significant statistical difference between the observation group and the control group in the near and long term incidence of stoma ischemia,edema and stenosis.The incidence of peristomy dermatitis in the observation group 1 and 6 months after surgery was significantly lower than that in the control group(2.60%vs12.50% vs 3.89%vs16.67%),and there was a significant statistical difference between the two groups.The incidence of parastatal hernia in the long-term observation group was lower than that in the control group,and there was a significant statistical difference between the two groups.One month after the operation,there was no significant statistical difference between the observation group and the control group in the statistical indicators of the change of defecation habits.Six months after the operation,the observation group felt better than the control group in defecation autonomously(28.57%vs13.89),and there was a significant statistical difference between the two groups.Twelve months after the operation,the observation group was better than the control group in terms of self-perception of defecation and defecation formation,with significant statistical difference(P<0.05).Conclusion: Compared with the traditional intraperitoneal stoma,laparoscopic combined abdominal perineal resection with extraperitoneal colostomy can reduce the incidence of peripheral dermatitis and parastatal hernia,effectively improve patients' defecation function,and have relatively good defecation habits,which is worthy of clinical promotion and application.