Effect of extraperitoneal colostomy on postoperative hernia and defecation function in patients with low rectal cancer

doi:10.3877/cma.j.issn.1674-392X.2018.03.006

Abstract

Abstract:

Objective

To analyze the effect of intraperitoneal colostomy and extraperitoneal colostomy on postoperative hernia and defecation function of artificial anal for patients undergoing abdominoperineal resection.

Methods

From April 2013 to April 2016, 43 cases of patients with rectal cancer in Lianshui People's hospital were enrolled. The patients were divided into observation groups with extraperitoneal stoma (21 cases, 1 cases were lost); and intraperitoneal colostomy patients as the control group (22 cases, 2 cases were lost). The postoperative complications and defecation ability were compared between the two groups.

Results

(1) No parastomal hernia in observation group, 2 in control group, the difference was significant, statistically significant (P<0.05); 4 cases of ostomy edema appeared in observation group and 1 in control group (P<0.05). (2) When comparing the control ability of artificial anal defecation in patients, no difference was found at 6 months follow-up, while the difference was statistically significant at 1year follow-up. The comprehensive evaluation of excellent and good rate were compared between the 2 groups at 6 months and 1 year, the difference was not significant at 6 months but significant at 1year.

Conclusion

Extraperitoneal colostomy can effectively reduce the incidence of parastomal hernia after abdominoperineal resection of rectal cancer, and can better control the defecation ability.

Key words: Laparoscopes, Ostomy, Complications

YanZhi Bu. Effect of extraperitoneal colostomy on postoperative hernia and defecation function in patients with low rectal cancer[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2018, 12(03): 183-186.

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Figures/Tables 5

References 15

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组别	例数	男/女	平均年龄(岁)	体质量指数(kg/m²)	造口时间(min)	手术时间(min)	出血量(ml)
观察组	20	11/9	59.87±9.27	20.59±1.59	21.16±45.38	233.51±40.25	104.56±47.97
对照组	20	12/8	59.36±8.96	21.37±1.89	19.28±5.25	221.61±40.17	119.47±55.12
t/χ²值	?	0.638	0.376	-1.798	1.741	1.487	-1.426
P值	?	0.465	0.701	0.072	0.083	0.142	0.149

组别	例数	男/女	平均年龄(岁)	体质量指数(kg/m²)	造口时间(min)	手术时间(min)	出血量(ml)
观察组	20	11/9	59.87±9.27	20.59±1.59	21.16±45.38	233.51±40.25	104.56±47.97
对照组	20	12/8	59.36±8.96	21.37±1.89	19.28±5.25	221.61±40.17	119.47±55.12
t/χ²值	?	0.638	0.376	-1.798	1.741	1.487	-1.426
P值	?	0.465	0.701	0.072	0.083	0.142	0.149

组别	例数	造口狭窄	造口回缩	造口脱垂	造口旁疝	造口周围炎	内疝	造口水肿	造口坏死、缺血	造口出血	合计
观察组	20	0	0	0	0	1(5)	0	4(20)	0	1(5)	6(30)
对照组	20	1(5)	1(5)	1(5)	2(10)	1(5)	0	1(5)	1(5)	0	8(40)
χ²值	?	4.621	3.024	0.490	5.481	-	-	4.290	5.130	4.621	0.728
P值	?	0.204	0.204	0.468	0.017	1.000	-	0.036	0.204	0.204	0.391

组别	例数	造口狭窄	造口回缩	造口脱垂	造口旁疝	造口周围炎	内疝	造口水肿	造口坏死、缺血	造口出血	合计
观察组	20	0	0	0	0	1(5)	0	4(20)	0	1(5)	6(30)
对照组	20	1(5)	1(5)	1(5)	2(10)	1(5)	0	1(5)	1(5)	0	8(40)
χ²值	?	4.621	3.024	0.490	5.481	-	-	4.290	5.130	4.621	0.728
P值	?	0.204	0.204	0.468	0.017	1.000	-	0.036	0.204	0.204	0.391

组别	例数	标准	问题1	问题2	问题3	问题4	问题5	问题6	问题7
对照组	20	A	12	14	13	12	16	15	12
		B	6	5	5	5	3	4	7
		C	2	1	2	3	1	1	1
观察组	20	A	10	10	9	8	11	12	8
		B	8	7	7	7	5	5	7
		C	2	3	4	5	4	3	5
χ²值	?	?	2.567	4.231	6.321	1.322	7.213	4.902	1.324
P值	?	?	0.153	0.053	0.119	0.293	0.069	0.065	0.067

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