RT Journal Article
SR Electronic
T1 Laparoscopic permanent sigmoid stoma creation through the extraperitoneal route versus transperitoneal route
JF Saudi Medical Journal
JO Saudi Med J
FD Prince Sultan Military Medical City
SP 159
OP 163
DO 10.15537/smj.2015.2.10203
VO 36
IS 2
A1 Wang, Feng-Bing
A1 Pu, Yu-Wei
A1 Zhong, Feng-Yun
A1 Lv, Xiao-Dong
A1 Yang, Zhi-Xue
A1 Xing, Chun-Gen
YR 2015
UL http://smj.org.sa/content/36/2/159.abstract
AB Objectives: To compare laparoscopic extraperitoneal colostomy with transperitoneal colostomy for construction of a permanent stoma by measuring the incidence of parastomal hernia, and other postoperative complications related to colostomy.Methods: The meta-analysis was carried out in the General Surgery Department of the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China in 2014. A literature search of Medline, EMBASE, Cochrane database, and the Chinese Biomedical Literature Database (CBM) from the years 1990 to 2014 was performed. The literature searches were carried out using medical subject headings and free-text words: extraperitoneal colostomy, transperitoneal colostomy, laparoscopic extraperitoneal colostomy, rectal cancer, laparoscopic abdominoperineal resection, parastomal hernia, permanent stoma, and colostomy-related complications. Two different reviewers carried out the search and evaluated studies independently.Results: One randomized controlled trial and 6 retrospective studies were included. A total of 378 patients (209 extraperitoneal colostomy and 169 transperitoneal colostomy) were identified. Our analysis showed that there was a significantly lower rate of parastomal hernia (odds ratio 0.10; 95% confidence interval 0.03-0.29, p<0.0001) in the extraperitoneal colostomy group. However, the other stoma-related complications were not significantly different between the 2 groups.Conclusion: Colostomy construction via the extraperitoneal route using a laparoscopic approach can largely reduce the incidence of parastomal hernia. Laparoscopic permanent sigmoid stoma creation through the extraperitoneal route should be the first choice after laparoscopic abdominoperineal resection.