Application of Pelvic Peritoneum Closure Combined with Extraperitoneal Colostomy in Laparoscopic Surgery for Low Rectal Cancer

Abstract

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.