Palliative stoma creation: comparison of laparoscopic vs conventional procedures.
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.
Scheidbach
H
H
Department of Surgery, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany. scheidbach@t-online.de
Ptok
H
H
Schubert
D
D
Kose
D
D
Hügel
O
O
Gastinger
I
I
Köckerling
F
F
Lippert
H
H
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
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