title: [Manufacture and application of laparoscopic extraperitoneal sigmoid colostomy].
abstract: OBJECTIVE
  To investigate the safety and feasibility of laparoscopic extraperitoneal sigmoid colostomy.
  
  
  METHODS
  Thirty-six patients with low rectal cancer undergoing laproscopic abdominoperineal resection from July 2011 to July 2012 were prospectively enrolled in the study and randomly divided into extraperitoneal colostomy group(EPC, n=18) and internal peritoneal colostomy group(IPC, n=18). Follow-up period was 4-16 (median, 7) months and postoperative complications were compared between two groups.
  
  
  RESULTS
  One case in EPC group was converted to IPC because of poor blood supply of the proximal sigmoid, who was eliminated from the subsequent analysis. Compared with the IPC group, the surgery time was longer in EPC group [(25.3±8.5) min vs. (14.7±6.4) min], while the difference was not statistically significant(P>0.05). Each group had 1 case of stoma ischemia, who both received the colostomy reconstructive surgery. The incidence of stoma edema was significantly higher in EPC group[35.3%(6/17) vs. 0, P<0.05). The early postoperative complications rate did not significantly different between the two groups[58.8%(10/17) vs. 27.8%(5/18), P>0.05]. The late postoperative complications rate was 22.2%(4/18) in IPC group, including 1 case of stoma prolapse, 1 case of stoma stenosis and 2 cases of parastomal hernia. No later postoperative complication occurred in EPC group.
  
  
  CONCLUSIONS
  Extraperitoneal sigmoid colostomy is an easy and safe procedure with lower late complications as compared to internal peritoneal sigmoid colostomy.
authors.affiliation: National Center of Colorectal Surgery, The Third Affiliated Hospital, Nanjing University of Traditional Chinese Medicine, Jiangsu Integrate Colorectal Oncology Center, Nanjing 210001, China. jinheiying@hotmail.com.
authors.forename: Hei-ying
authors.initials: HY
authors.lastname: Jin
authors.forename: Yong-hong
authors.initials: YH
authors.lastname: DU
authors.forename: Xiao-feng
authors.initials: XF
authors.lastname: Wang
authors.forename: Hang
authors.initials: H
authors.lastname: Yao
authors.forename: Kun-lan
authors.initials: KL
authors.lastname: Wu
authors.forename: Bei
authors.initials: B
authors.lastname: Zhang
authors.forename: Jin-hao
authors.initials: JH
authors.lastname: Zhang
mesh_terms: D000005:Abdomen; D012809:Colon, Sigmoid / Q000601:surgery*; D003125:Colostomy; D006801:Humans; D010535:Laparoscopy; D010502:Perineum; D010537:Peritoneum; D011183:Postoperative Complications; D012004:Rectal Neoplasms; D012007:Rectum; D054047:Surgical Stomas