Volume 19 Issue 6
Jun.  2021
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Article Navigation >  Chinese Journal of General Practice  > 2021  >  19(6): 929-931,1060
JIA Wei, LIU Mu-lin, ZHU Bing, LUO Jie. Application of extraperitoneal oblique tunnel sigmoidostomy in laparoscopic Miles operation[J]. Chinese Journal of General Practice, 2021, 19(6): 929-931,1060. doi: 10.16766/j.cnki.issn.1674-4152.001952
Citation: JIA Wei, LIU Mu-lin, ZHU Bing, LUO Jie. Application of extraperitoneal oblique tunnel sigmoidostomy in laparoscopic Miles operation[J]. Chinese Journal of General Practice, 2021, 19(6): 929-931,1060. doi: 10.16766/j.cnki.issn.1674-4152.001952
shu

Application of extraperitoneal oblique tunnel sigmoidostomy in laparoscopic Miles operation

doi: 10.16766/j.cnki.issn.1674-4152.001952

  • Department of Gastrointestinal Surgery, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China

Funds:

 KJ2017A219

  • Received Date: 2020-09-12
    Available Online: 2022-02-16
    Abstract
  •   Objective  To investigate the clinical effect of extraperitoneal oblique tunnel sigmoidostomy in laparoscopic abdominoperineal radical resection of rectal cancer.,  Methods  The clinical data of 104 patients with low rectal cancer who underwent laparoscopic abdominoperineal resection (Miles) from January 2015 to December 2017 in the First Affiliated Hospital of Bengbu Medical College were analysed retrospectively. Among them, 52 patients in the observation group were treated with laparoscopic Miles operation combined with extraperitoneal oblique tunnel sigmoidostomy, and 52 patients in the control group were treated with laparoscopic Miles operation combined with intraperitoneal sigmoidostomy. Follow-up was conducted for 24-60 months wherein the first time to exhaust time, the first defecation time, postoperative hospital stay, short-term complications (stoma separation, stoma edema, stoma ischemia or necrosis, stoma intestinal rupture, stoma intestinal obstruction), long-term complications (stoma retraction, stoma stenosis, parastomal hernia, stoma prolapse) and defecation feeling in the sixth month after operation) were statistically analysed.  Results  The first exhaust time [(3.31±0.42) d] and the first defecation time [(4.18±0.55) d] in the observation group were higher than those in the control group [(3.04±0.30) d] and [(3.93±0.42) d], and the difference was statistically significant (all P < 0.05). However, no significant difference was noted in postoperative hospital stay between the observation group [(11.96±1.62) d] and the control group [(11.64±2.32) d], P>0.05. No significant difference was observed in the short-term complication rate of stoma (15.385% vs. 17.308%) between the two groups (P>0.05) as well, but significant differences were noted in the long-term complication rate of stoma (5.769% vs. 32.692%) and the rate of defecation feeling in the sixth month after operation (86.538% vs. 40.385%) between the two groups (all P < 0.05).  Conclusion  Using extraperitoneal oblique tunnel sigmoidostomy in laparoscopic Miles operation is safe and feasible for patients with low rectal cancer. This approach can significantly reduce the incidence of long-term complications after stoma and increase the rate of defecation.

     

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