Extraperitoneal Colostomy Versus Transperitoneal Colostomy After Laparoscopic Abdominoperineal Resection for Rectal Cancer: A Systematic Review and Meta-analysis.

IF 1.1 4区医学 Q3 SURGERY

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques Pub Date : 2025-04-04 DOI:10.1097/SLE.0000000000001365

Xin Jin, Yong Li, Bingchen Chen, Boan Zheng

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引用次数: 0

Abstract

Purpose: This study aimed to compare extraperitoneal colostomy (EPC) with transperitoneal colostomy (TPC) after laparoscopic abdominoperineal resection (APR) for rectal cancer regarding postoperative complications.

Method: A literature search was performed on PubMed, Ovid, and Cochrane Databases for studies comparing EPC with TPC after laparoscopic APR for rectal cancer. The last search was performed on June 4, 2024. The primary outcome was the incidence of parastomal hernia. The Review Manager (version 5.3) was used for data analysis.

Results: A total of 9 studies with 1002 patients were included in this meta-analysis. Among the enrolled literatures, one was randomized clinical trials, and others were retrospectively case-control designed. EPC showed significant efficiency in preventing parastomal hernia (P<0.001, OR=0.16, 95% CI: 0.09-0.28, I2=0%). Besides, the results indicated that the EPC group was associated with significantly less incidence of stoma retraction (P=0.02, OR=0.23, 95% CI: 0.06-0.81, I2=0%), stoma prolapse (P=0.002, OR=0.18, 95% CI: 0.06-0.54, I2=0%), and total stoma-related complications (P<0.001, OR=0.50, 95% CI: 0.33-0.74, I2=26%). In addition, no significant difference was observed between the 2 groups in terms of the total operative time or the time for colostomy creation.

Conclusion: Current data demonstrated the significant efficiency of EPC in preventing parastomal hernia after laparoscopic APR for rectal cancer. Besides, the clinical safety and feasibility of EPC were also indicated. The EPC procedure could be widely recommended for permanent colostomy in clinical practice.

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腹腔镜腹会阴直肠癌切除术后腹膜外结肠造口术与经腹膜结肠造口术：系统回顾和荟萃分析。

目的：本研究旨在比较腹腔镜腹会阴切除术（APR）后直肠癌腹腔外结肠造口术（EPC）与经腹腔结肠造口术（TPC）的术后并发症。方法：检索PubMed、Ovid和Cochrane数据库，比较腹腔镜直肠癌APR术后EPC和TPC的研究。最后一次搜索是在2024年6月4日。主要结果是造口旁疝的发生率。Review Manager（5.3版本）用于数据分析。结果：本荟萃分析共纳入9项研究，共1002例患者。纳入的文献中，1篇为随机临床试验，其余为回顾性病例对照设计。结论：目前的数据表明，EPC在预防直肠癌腹腔镜APR术后造口旁疝方面有显著的效果。此外，还指出了EPC的临床安全性和可行性。EPC手术在临床上可广泛推荐用于永久性结肠造口。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques 医学-外科

CiteScore

2.00

自引率

10.00%

发文量

103

审稿时长

3-8 weeks

期刊介绍： Surgical Laparoscopy Endoscopy & Percutaneous Techniques is a primary source for peer-reviewed, original articles on the newest techniques and applications in operative laparoscopy and endoscopy. Its Editorial Board includes many of the surgeons who pioneered the use of these revolutionary techniques. The journal provides complete, timely, accurate, practical coverage of laparoscopic and endoscopic techniques and procedures; current clinical and basic science research; preoperative and postoperative patient management; complications in laparoscopic and endoscopic surgery; and new developments in instrumentation and technology.