The Contrastive Analysis of Two Kinds of Sigmoid Colostomy in Abdominal Perineal Resection_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 CHENShi-jie ¹ , LIUXiu-lan ² , PENGChao ¹ , CHENZhuo ¹

1. The First Department of General Surgery, Neijiang Second People's Hospital of Sichuan Province, Neijiang 614199, Sichuan Province, China;
2. Pathological Department, Neijiang Second People, s Hospital of Sichuan Province, Neijiang 614199, Sichuan Province, China;

Corresponding?author：

CHENShi-jie, Email: chensj577@126.com

Keywords：

Sigmoid colostomy; Extraperitoneal; Intraperitoneal; Colostomy complication; Colostomy function

DOI：

10.7507/1007-9424.20160122

Video：

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Objective To contrastive the clinical results of intraperitoneal sigmoid colostomy and extraperitoneal sigmoid colostomy in abdominal perineal resection. Methods The clinical data of 172 patients who underwent abdominal perineal resection from March 2010 to March 2014 were retrospectively analyzed.Sixty cases were performed the intraperitoneal sigmoid colostomy (intraperitoneal group), seventy-six cases were performed the extraperitoneal sigmoid colostomy (extraperitoneal group), and thirty-six cases were performed the functional exercise after extraperitoneal sigmoid colostomy (functional exercise group). The operation situation, postoperative complications, and colostomy function of three groups of patients were compared. Results ①Operation situation: The colostomy location selection, operative time, intraoperative blood loss, and postoperative hospital stay of the three groups had no statistically significant differences (P > 0.05). The postoperative first exhaust and defecate time of the intraperitoneal group and the functional exercise group were obviously earlier than the extraperitoneal group, the difference had statistical significance (P < 0.05).②The postoperative complications: The postoperative complications rates of the extraperitoneal group and functional exercise group were lower than the intraperitoneal group, had statistically significant difference (P < 0.05), the functional exercise group was lower than the extraperitoneal group, the difference had statistical significance (P < 0.05).③The colostomy function:The patient' proportion that > 30 s of appeared time of defecation signals in the extraperitoneal group was significantly higher than the intraperitoneal group, and the functional exercise group was higher than that in the extraperitoneal group, the difference were statistically significant (P < 0.05). The patient' proportion that > 2 min of autonomous control of defecation to discharge feces time after the bowel signal appears in the extraperitoneal group was significantly higher than the intraperitoneal group, and the functional exercise group was higher than that in the extraperitoneal group, the difference were statistically significant (P < 0.05). Conciusions The intraperitoneal sigmoid colostomy has less colostomy related complications than extraperitoneal sigmoid colostomy in abdominal perineal resection. The control, and defecate ability are better. Postoperative function exercise can further reduce the colostomy complications and improve the function of colostomy.

Citation： CHENShi-jie, LIUXiu-lan, PENGChao, CHENZhuo. The Contrastive Analysis of Two Kinds of Sigmoid Colostomy in Abdominal Perineal Resection. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(4): 462-466. doi: 10.7507/1007-9424.20160122 Copy

1.	張國陽, 劉逸, 揭志剛, 等.管狀吻合器在腹腔鏡Miles術中乙狀結腸腹膜外造瘺的臨床應用.世界華人消化雜志, 2015, 23(5): 828-833.
2.	劉乃青, 孫淑香, 周忠晉, 等.腹膜外造口和盆底腹膜重建預防腹腔鏡下Miles術后造口旁疝和盆底粘連梗阻.中華普通外科雜志, 2014, 29(10): 804-805.
3.	王青兵, 肖建安.腹膜外途徑結腸造口在Miles術中的應用.第三軍醫大學學報, 2014, 36(7): 725-727.
4.	殷紅專, 梁逸超, 閆兆鵬, 等.傳統開腹與腹腔鏡直腸癌根治術經腹膜外隧道乙狀結腸造口的患者生活質量隨訪研究.中國內鏡雜志, 2013, 19(5): 470-472.
5.	楊平, 彭翔, 鄧建中, 等.腹腔鏡輔助經腹膜外隧道和腹直肌的乙狀結腸吻合器造口術.實用醫學雜志, 2010, 26(18): 3393-3395.
6.	李建業, 鄧建武, 苗永昌, 等.預防性橫結腸造瘺與末端回腸造瘺在直腸癌低位前切除術中應用比較.中國普通外科雜志, 2015, 24(10): 1439-1443.
7.	喬小平, 張桂華, 陳名林, 等.腸穿孔腹腔感染腸造口術的應用研究.中華醫院感染學雜志, 2015, 25(18): 4243-4245.
8.	邢國統.隧道式腹膜外結腸造口在Miles手術中的應用效果.江蘇醫藥, 2012, 38(8): 985-986.
9.	陳剛, 呂超.經腹直肌前后鞘乙狀結腸異位造口術在直腸癌治療中的應用觀察.山東醫藥, 2008, 48(47): 46.
10.	鮑傳慶, 吳小龍, 張淳, 等.腹膜外隧道式乙狀結腸造口成形術在Miles手術的應用.江蘇醫藥, 2006, 32(1): 88.
11.	張憲波, 顏育祥, 胡曉清, 等.乙狀結腸成形術在腹膜外結腸造口術中的應用.中華普通外科雜志, 2009, 24(12): 1025-1026.
12.	王舉, 韓樹海, 楊雨民, 等.應用管狀吻合器經腹膜外途徑結腸造口術.中華醫學雜志, 2010, 90(10): 687-689.
13.	別夢軍, 魏正強.兩種乙狀結腸造瘺方式預防造瘺口旁疝的比較.實用醫學雜志, 2012, 28(16): 2735-2736.
14.	Dong LR, Zhu YM, Xu Q, et al. Clinical evaluation of extraperitonealcolostomy without damaging the muscle layer of the abdominal wall. J Int Med Res, 2012, 40(4): 1410-1416.
15.	聶霽, 汪曉東, 李立, 等.預防性造口術對結直腸癌患者并發癥的影響.實用醫學雜志, 2015, 31(17): 2777-2779.
16.	戴志慧, 杜金林.保護性橫結腸襻式造口對腹腔鏡直腸癌前切除術后吻合口漏及狹窄的影響.中華消化外科雜志, 2014, 13(7): 535-538.
17.	黃曉斌, 李世昌.兩種腸造口術在治療老年梗阻性乙狀結腸癌和高位直腸癌中的應用.實用醫學雜志, 2014, 30(10): 1584-1586.
18.	張憲波, 顏育祥.乙狀結腸成形術在腹膜外結腸造口術中的應用.中華普通外科雜志, 2009, 24(12): 1025-1026.
19.	Lian L, Wu XR, He XS, et al. Extraperitoneal vs. intraperitoneal route for permanent colostomy: a meta-analysis of 1 071 patients. Int J Colorectal Dis, 2012, 27(1): 59-64.
20.	Shiraishi T, Tomizawa N, Ando T, et al.Extraperitonealcolostomy in laparoscopic abdominoperineal resection using a hand inserted from the perineal side. Asian J Endosc Surg, 2014, 7(1): 89-92.
21.	Heiying J, Yonghong D, Xiaofeng W, et al. A study of laparoscopic extraperitoneal sigmoid colostomy after abdomino-perineal resection for rectal cancer. Gastroenterol Rep (Oxf), 2014, 2(1): 58-62.
22.	Wang FB, Pu YW, Zhong FY, et al. Laparoscopic permanent sigmoid stoma creation through the extraperitoneal route versus transperitoneal route. A meta-analysis of stoma-related complications. Saudi Med J, 2015, 36(2): 159-163.
23.	Wang J, Dou Z, Wang T, et al. Circular stapler-assisted extraperitonealcolostomy. Dig Surg, 2010, 27(6): 521-524.
24.	崔冀, 向軍, 黃美近, 等.應用膨體聚四氟乙烯補片行乙狀結腸造口腹膜內固定對造口旁疝的預防.中華胃腸外科雜志, 2009, 12(5): 480-482.
25.	王立義.兩種乙狀結腸造口術并發癥發生情況的比較.山東醫藥, 2005, 45(9): 33-34.

1. 張國陽, 劉逸, 揭志剛, 等.管狀吻合器在腹腔鏡Miles術中乙狀結腸腹膜外造瘺的臨床應用.世界華人消化雜志, 2015, 23(5): 828-833.
2. 劉乃青, 孫淑香, 周忠晉, 等.腹膜外造口和盆底腹膜重建預防腹腔鏡下Miles術后造口旁疝和盆底粘連梗阻.中華普通外科雜志, 2014, 29(10): 804-805.
3. 王青兵, 肖建安.腹膜外途徑結腸造口在Miles術中的應用.第三軍醫大學學報, 2014, 36(7): 725-727.
4. 殷紅專, 梁逸超, 閆兆鵬, 等.傳統開腹與腹腔鏡直腸癌根治術經腹膜外隧道乙狀結腸造口的患者生活質量隨訪研究.中國內鏡雜志, 2013, 19(5): 470-472.
5. 楊平, 彭翔, 鄧建中, 等.腹腔鏡輔助經腹膜外隧道和腹直肌的乙狀結腸吻合器造口術.實用醫學雜志, 2010, 26(18): 3393-3395.
6. 李建業, 鄧建武, 苗永昌, 等.預防性橫結腸造瘺與末端回腸造瘺在直腸癌低位前切除術中應用比較.中國普通外科雜志, 2015, 24(10): 1439-1443.
7. 喬小平, 張桂華, 陳名林, 等.腸穿孔腹腔感染腸造口術的應用研究.中華醫院感染學雜志, 2015, 25(18): 4243-4245.
8. 邢國統.隧道式腹膜外結腸造口在Miles手術中的應用效果.江蘇醫藥, 2012, 38(8): 985-986.
9. 陳剛, 呂超.經腹直肌前后鞘乙狀結腸異位造口術在直腸癌治療中的應用觀察.山東醫藥, 2008, 48(47): 46.
10. 鮑傳慶, 吳小龍, 張淳, 等.腹膜外隧道式乙狀結腸造口成形術在Miles手術的應用.江蘇醫藥, 2006, 32(1): 88.
11. 張憲波, 顏育祥, 胡曉清, 等.乙狀結腸成形術在腹膜外結腸造口術中的應用.中華普通外科雜志, 2009, 24(12): 1025-1026.
12. 王舉, 韓樹海, 楊雨民, 等.應用管狀吻合器經腹膜外途徑結腸造口術.中華醫學雜志, 2010, 90(10): 687-689.
13. 別夢軍, 魏正強.兩種乙狀結腸造瘺方式預防造瘺口旁疝的比較.實用醫學雜志, 2012, 28(16): 2735-2736.
14. Dong LR, Zhu YM, Xu Q, et al. Clinical evaluation of extraperitonealcolostomy without damaging the muscle layer of the abdominal wall. J Int Med Res, 2012, 40(4): 1410-1416.
15. 聶霽, 汪曉東, 李立, 等.預防性造口術對結直腸癌患者并發癥的影響.實用醫學雜志, 2015, 31(17): 2777-2779.
16. 戴志慧, 杜金林.保護性橫結腸襻式造口對腹腔鏡直腸癌前切除術后吻合口漏及狹窄的影響.中華消化外科雜志, 2014, 13(7): 535-538.
17. 黃曉斌, 李世昌.兩種腸造口術在治療老年梗阻性乙狀結腸癌和高位直腸癌中的應用.實用醫學雜志, 2014, 30(10): 1584-1586.
18. 張憲波, 顏育祥.乙狀結腸成形術在腹膜外結腸造口術中的應用.中華普通外科雜志, 2009, 24(12): 1025-1026.
19. Lian L, Wu XR, He XS, et al. Extraperitoneal vs. intraperitoneal route for permanent colostomy: a meta-analysis of 1 071 patients. Int J Colorectal Dis, 2012, 27(1): 59-64.
20. Shiraishi T, Tomizawa N, Ando T, et al.Extraperitonealcolostomy in laparoscopic abdominoperineal resection using a hand inserted from the perineal side. Asian J Endosc Surg, 2014, 7(1): 89-92.
21. Heiying J, Yonghong D, Xiaofeng W, et al. A study of laparoscopic extraperitoneal sigmoid colostomy after abdomino-perineal resection for rectal cancer. Gastroenterol Rep (Oxf), 2014, 2(1): 58-62.
22. Wang FB, Pu YW, Zhong FY, et al. Laparoscopic permanent sigmoid stoma creation through the extraperitoneal route versus transperitoneal route. A meta-analysis of stoma-related complications. Saudi Med J, 2015, 36(2): 159-163.
23. Wang J, Dou Z, Wang T, et al. Circular stapler-assisted extraperitonealcolostomy. Dig Surg, 2010, 27(6): 521-524.
24. 崔冀, 向軍, 黃美近, 等.應用膨體聚四氟乙烯補片行乙狀結腸造口腹膜內固定對造口旁疝的預防.中華胃腸外科雜志, 2009, 12(5): 480-482.
25. 王立義.兩種乙狀結腸造口術并發癥發生情況的比較.山東醫藥, 2005, 45(9): 33-34.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

The Contrastive Analysis of Two Kinds of Sigmoid Colostomy in Abdominal Perineal Resection

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