Background: In the treatment of colorectal cancer, laparoscopic surgery has seen a significant amount of success. Reducing the risk of postoperative complications and improving patients’ quality of life can be accomplished by appropriately employing pelvic peritoneal repair and sigmoid colostomy when appropriate. Objective: To compare fusion closure of pelvic peritoneum combined with extraperitoneal colostomy with non-closure of pelvic peritoneum combined with intraperitoneal colostomy in patients with low rectal cancer who had permanent colostomy. Methods: Low rectal cancer patients admitted to Hengshui People’s Hospital for permanent colostomy were evaluated. The participants were divided into two groups: an observation and a control group. All 30 cases in the observation group underwent pelvic peritoneum closure and extraperitoneal colostomy, while the other 30 cases in the control group underwent intraperitoneal colostomy. The C-reactive protein (CRP) levels of the participants in both groups were evaluated for 6 months to 2 years (24 h before, 24 h after, 48 h after, 96 h after surgery). Results: Comparing the colostomy operative time, time to first passage of flatus postoperatively, time to first defecation postoperatively, length of hospital stay, laboratory indicators, stoma-related complications, colostomy function, etc., the colostomy operative time significantly differed between the two groups (P < 0.05); the observation group did considerably better than the control group in terms of stoma-related complications and bowel movement control 6 months after surgery (P < 0.05); and although serum CRP levels increased in both groups 48 h after surgery, the difference was significant (P < 0.05). Conclusion: Extraperitoneal colostomy can improve the quality of life of patients with permanent stoma and reduce the occurrence of stoma-related complications. Thus, this technique is worthy of promotion in clinical practice.
National Cancer Center, China, Expert Group of the Development of China Guideline for the Screening, Early Detection and Early Treatment of Colorectal Cancer, 2021, Guidelines for Screening, Early Diagnosis and Treatment of Colorectal Cancer in China (2020, Beijing). Chinese Journal of Oncology, 43(1): 16–38.
Wu Z, Deng Y, 2017, The Influence of Differences Between the East and West in Colorectal Cancer Epidemiology on Tumor Location. Chinese Journal of Oncology Prevention and Treatment, 9(5): 356–360.
Expert Group on Chinese Colorectal Cancer Diagnosis and Treatment Standards (2020 Edition), 2020, National Health Commission Chinese Colorectal Cancer Diagnosis and Treatment Standards (2020 Edition). Chinese Journal of Gastrointestinal Surgery, 23(6): 521–540.
Zheng M, Ma J, 2019, Updates of the 2018 Edition of “Laparoscopic Colorectal Cancer Radical Surgery Operation Guidelines”. Chinese Journal of Surgery, 57(3): 224–226.
Lian L, Lan P, 2021, Interpretation of the National Health Commission’s Chinese Colorectal Cancer Diagnosis and Treatment Standards (2020 Edition) – Surgery. Journal of Clinical Surgery, 29(1): 10–12.
Wang G, Hu X, Zhang N, et al., 2021, Prevention and Treatment Strategies for Major Complications After 30 Years of Laparoscopic Rectal Cancer Surgery in China. Chinese Journal of Operative Procedures of General Surgery, 15(1): 14–19.
Rahbari NN, Weitz J, Hohenberger W, et al., 2010, Definition and Grading of Anastomotic Leakage Following Anterior Resection of the Rectum: A Proposal by the International Study Group of Rectal Cancer. Surgery, 147(3): 339–351.
Keller DS, Ibarra S, Flores-Gonzalez JR, et al., 2016, Outcomes for Single Incision Laparoscopic Colectomy Surgery in Obese Patients: A Case-Matched Study. Surg Endosc, 30(2): 739–744.
Wang Y-L, Zhang X, Mao J-J, et al., 2018, Application of Modified Primary Closure of the Pelvic Floor in Laparoscopic Extralevator Abdominal Perineal Excision for Low Rectal Cancer. World Journal of Gastroenterology, 2018(30): 3440–3447.
Li G, Zhao L, 2011, Anatomy Summary of Laparoscopic Radical Resection of Colorectal Cancer. Chinese Journal of Practical Surgery, 31(9): 844–848.
Chi P, Wang X, 2021, Total Mesenterectomy with Partial Denonvilliers’ Fascia: Balance Between Oncology and Function. Chinese Journal of Digestive Surgery, 20(1): 78–84.
Sakr A, Sauri F, Alessa M, et al., 2020, Assessment and Management of Low Anterior Resection Syndrome After Sphincter Preserving Surgery for Rectal Cancer. Chinese Medical Journal, 133(15): 1824–1833.
Faylona JMV, 2018, Invited Comment to: European Hernia Society Guidelines on Prevention and Treatment of Parastomal Hernias. Hernia: The Journal of Hernias and Abdominal Wall Surgery, 22(1): 203.
Zieli?ski T, Czy?ewski P, Szczepkowski M, 2016, The Usefulness of Anorectal Manometry in Patients with a Stoma Before and After Surgery to Restore the Continuity of the Gastrointestinal Tract. Polski Przeglad Chirurgiczny, 88(1): 1–6.
Lian L, Wu XR, He XS, 2012, Extraperitoneal Vs. Intraperitoneal Route for Permanent Colostomy: A Meta-Analysis of 1,071 Patients. International Journal of Colorectal Disease, 27(1): 59–64.
Cross AJ, Buchwald PL, Frizelle FA, et al., 2017, Meta-Analysis of Prophylactic Mesh to Prevent Parastomal Hernia. The British Journal of Surgery, 104(3): 179–186.
Xu B, Zhou L, Duan J, et al., 2021, Meta-Analysis of the Application Value of Preventive Patch Placement in the Prevention of Parastomal Hernia. Chinese Journal of General Surgery, 30(4): 386–398.
Guraya SY, 2015, Association of Type 2 Diabetes Mellitus and the Risk of Colorectal Cancer: A Meta-Analysis and Systematic Review. World Journal of Gastroenterology, 21(19): 6026–6031.
Lee SC, Huh JW, Lee WY, et al., 2020, Prognostic Value of Serum Inflammatory Markers in Colorectal Cancer. International Journal of Colorectal Disease, 35(7): 1211–1219.
Fingren J, Lindholm E, Petersén C, et al., 2018, A Prospective, Explorative Study to Assess Adjustment 1 Year After Ostomy Surgery Among Swedish Patients. Ostomy/Wound Management, 64(6): 12–22.