To compare the short-term effects of a conventional stoma approach with tunnel stoma approach that preserves the integrity of the posterior sheath and, to investigate the clinical efficacy of tunnel stoma approach in preventing parastomal hernia.

Seventy patients who underwent permanent sigmoid colostomy for low rectal cancer in the First Department of General Surgery of Shaanxi Provincial People's Hospital from March 2014 to April 2021 were retrospectively analyzed. All patients underwent laparoscopic transabdominal perineal combined with radical resection of rectal cancer. The patients were divided into 40 cases in the control group (conventional colostomy approach) and 30 cases in the experimental group (tunnel stoma approach with preservation of the posterior sheath intact) according to the stoma methods. General clinical data, duration of surgery, postoperative stoma evacuation time, postoperative feeding time, stoma-related complications, incidence of parastomal hernia were compared and analyzed.

There were no significant differences between the two groups in terms of gender, age, BMI, TNM stage, duration of surgery, intraoperative bleeding, postoperative stoma evacuation time, postoperative feeding time, stoma complications and incision infection rate. (P>0.05). The incidence of parastomal hernia in the control group was significantly higher than that in the experimental group (27.5% vs 0, P<0.05). The majority of the stoma patients the control group had parastomal hernias between 2 weeks and 3 years after surgery.

A tunnel stoma with the posterior sheath intact can prevent parastomal hernia in the short term.