title: Palliative stoma creation: comparison of laparoscopic vs conventional procedures.
abstract: BACKGROUND
  The creation of a stoma is an established therapeutic concept for the palliation of non-resectable rectal carcinomas and advanced tumours infiltrating the pelvis.
  
  
  METHODS
  In two prospective country-wide multicentre studies, each conducted over a similar period of time, the peri-operative course and postoperative short-term outcomes of laparoscopic vs laparotomy-based stoma construction were compared.
  
  
  RESULTS
  A total of 90 patients underwent palliative laparoscopic construction; 550 patients received a stoma via a laparotomy. The intra-operative complication rate was lower after open surgery than after laparoscopic surgery (2.7 vs 5.6%; p = 0.15), although the difference was not significant. With regard to general (30.9 vs 15.6%; p = 0.003) and also specific postoperative complications (13.8 vs 5.6%; p = 0.029), however, a significant advantage of the laparoscopic approach was seen. Furthermore, mortality in the laparoscopic group was also significantly lower (4.4 vs 14.0%; p = 0.011).
  
  
  CONCLUSIONS
  Palliative stoma done via laparoscopy had significantly better outcomes in terms of postoperative morbidity and mortality in comparison with the open surgical procedure.
authors: Department of Surgery, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany. scheidbach@t-online.de
authors: H
authors: H
authors: Scheidbach
authors: H
authors: H
authors: Ptok
authors: D
authors: D
authors: Schubert
authors: D
authors: D
authors: Kose
authors: O
authors: O
authors: Hügel
authors: I
authors: I
authors: Gastinger
authors: F
authors: F
authors: Köckerling
authors: H
authors: H
authors: Lippert
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D003125:Colostomy / Q000379:methods* / Q000401:mortality; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D009361:Neoplasm Invasiveness; D010166:Palliative Care / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D011446:Prospective Studies; D011786:Quality Control; D012086:Reoperation; D016019:Survival Analysis
references: Dis Colon Rectum. 1997 Jan;40(1):112-5
references: 9102252
references: Surg Endosc. 1997 Jan;11(1):19-23
references: 8994982
references: Int J Colorectal Dis. 1998;13(5-6):251-5
references: 9870171
references: Tech Coloproctol. 2005 Apr;9(1):9-14
references: 15868492
references: Dis Colon Rectum. 1998 Feb;41(2):190-4
references: 9556243
references: Surg Laparosc Endosc Percutan Tech. 2007 Apr;17(2):79-82
references: 17450084
references: Chirurg. 1997 Mar;68(3):225-30
references: 9198563
references: Semin Laparosc Surg. 2003 Dec;10(4):191-6
references: 14760467
references: Oncology (Williston Park). 2000 Aug;14(8):1131-43; discussion 1143-4, 1147-9
references: 10989824
references: Br J Surg. 1998 Feb;85(2):226-8
references: 9501822
references: Singapore Med J. 1999 May;40(5):333-5
references: 10489490
references: Chirurg. 1999 Jul;70(7):785-8
references: 10448586