The application of extraperitoneal laparocolostomy in laparoscopic radical resection for rectal carcinoma

doi:10.3877/cma.j.issn.2095-3224.2016.01.11

Abstract

Abstract:

Objective

To investigate the value of application of extraperitoneal laparocolostomy in laparoscopic radical resection of rectal carcinoma.

Methods

In this retrospective study, 112 rectal cancer patients under laparoscopic radical resection were enrolled, including 48 patients with extraperitoneal laparocolostomy and 64 patients with traditional laparocolostomy. Differences of clinical characters, early and long-term stomal complications after laparocolostomy between the two groups were analyzed.

Results

There were no significant differences in the incidence of perioperative complications, early stomal complications, and the time of first passing flatus and defecation between the two groups. Still, the hospitalization time between the two groups was no statistical significance. However, patients in extraperitoneal group, compared with the other group, showed lower rates of incident of para-stoma hernia and stomal prolapse (P<0.05).

Conclusions

Although patients with laparoscopic extraperitoneal laparocolostomy had a similar incidence of early stomal complications with patients under traditional laparocolostomy, they had a lower incident of long-term stomal complications and a better quality of life, which proved that laparoscopic extraperitoneal laparocolostomy is of high clinical value.

Key words: Rectal neoplasms, Laparoscopy, Surgical procedures, operative

Yanjun Wang, Qingbing Wang, Jian′an Xiao, Tianchen Huang, Yong Zhang, Dongxiao Bai. The application of extraperitoneal laparocolostomy in laparoscopic radical resection for rectal carcinoma[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2016, 05(01): 56-59.

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URL: https://zhjzcjbdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-3224.2016.01.11

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References 14

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临床指标		观察组n=48	对照组n=64	χ²值	P值
性别（男/女）[例（%）]		30/18（62.5/37.5）	39/25（60.9/39.1）	0.028	0.866
年龄（岁，±s）		67.2±3.6	65.8±4.1	0.124	0.612
TNM分期[例（%）]		?	?	1.044	0.307
?	Ⅰ/Ⅱ期	5/22（10.4/45.9）	6/31（9.4/48.4）	?	?
?	Ⅲ/Ⅳ期	20/1（41.7/2.0）	26/1（40.6/1.6）	?	?
肺功能障碍[例（%）]		4/48（8.3）	13/64（20.3）	3.057	0.080
体质指数[例（%）]		?	?	0.148	0.700
?	低/正常体重[例（%）]	8/20（16.7/41.7）	5/30（7.8/46.9）	?	?
?	超重/肥胖	13/7（27.1/14.5）	15/14（23.4/21.9）	?	?

临床指标		观察组n=48	对照组n=64	χ²值	P值
性别（男/女）[例（%）]		30/18（62.5/37.5）	39/25（60.9/39.1）	0.028	0.866
年龄（岁，±s）		67.2±3.6	65.8±4.1	0.124	0.612
TNM分期[例（%）]		?	?	1.044	0.307
?	Ⅰ/Ⅱ期	5/22（10.4/45.9）	6/31（9.4/48.4）	?	?
?	Ⅲ/Ⅳ期	20/1（41.7/2.0）	26/1（40.6/1.6）	?	?
肺功能障碍[例（%）]		4/48（8.3）	13/64（20.3）	3.057	0.080
体质指数[例（%）]		?	?	0.148	0.700
?	低/正常体重[例（%）]	8/20（16.7/41.7）	5/30（7.8/46.9）	?	?
?	超重/肥胖	13/7（27.1/14.5）	15/14（23.4/21.9）	?	?

并发症	腹膜外组	腹腔组	统计值	P值
出血、感染	8.3（4/48）	12.5（8/64）	0.202	0.654
皮肤黏膜分离	4.2（2/48）	9.4（6/64）	?	0.463*
造口黏膜缺血坏死	2.1（1/48）	6.3（4/64）	?	0.390*
造口回缩、狭窄	4.2（2/48）	9.4（6/64）	?	0.699*
造口旁疝	2.1（1/48）	18.8（12/64）	7.426	0.006
造口脱垂	0.0（0/48）	4.7（3/64）	?	0.036*
住院天数（d）	8.5±2.9	10.3±3.5	-0.978	0.337
首次排气时间（d）	3.3±1.0	3.9±1.5	-0.549	0.588
首次排便时间（d）	4.1±1.1	4.4±0.9	-0.846	0.406

并发症	腹膜外组	腹腔组	统计值	P值
出血、感染	8.3（4/48）	12.5（8/64）	0.202	0.654
皮肤黏膜分离	4.2（2/48）	9.4（6/64）	?	0.463*
造口黏膜缺血坏死	2.1（1/48）	6.3（4/64）	?	0.390*
造口回缩、狭窄	4.2（2/48）	9.4（6/64）	?	0.699*
造口旁疝	2.1（1/48）	18.8（12/64）	7.426	0.006
造口脱垂	0.0（0/48）	4.7（3/64）	?	0.036*
住院天数（d）	8.5±2.9	10.3±3.5	-0.978	0.337
首次排气时间（d）	3.3±1.0	3.9±1.5	-0.549	0.588
首次排便时间（d）	4.1±1.1	4.4±0.9	-0.846	0.406

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