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.
Materials and 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).
Conclusion
Palliative stoma done via laparoscopy had significantly better outcomes in terms of postoperative morbidity and mortality in comparison with the open surgical procedure.
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References
Oliveira L (2003) Laparoscopic stoma creation and closure. Semin Laparosc Surg 10:191–196
Schwandner O, Schiedeck THK, Bruch HP (1998) Stoma creation for fecal diversion: is the laparoscopic technique appropriate? Int J Colorectal Dis 13:251–255
Marusch F, Koch A, Kube R, Gastinger I (1999) Laparoscopic creation of stomas—an ideal single indication in minimally invasive surgery. Chirurg 70:785–788
Saeger HD, Wehrmann U (1997) Palliative laparoscopic techniques for surgery of malignant tumors. Chirurg 68:225–230
Nyam DC, Ho YH, Leong AF, Seow-Choen F (1999) Palliative surgery for locally recurrent colorectal cancer. Singap Med J 40:333–335
Liu J, Bruch HP, Farke S, Nolde J, Schwandner O (2005) Stoma formation for fecal diversion: a plea for the laparoscopic approach. Tech Coloproctology 9:9–14
Young CJ, Eyers AA, Salomon MJ (1998) Defunctioning of the anorectum—historical controlled study of laparoscopic vs. open procedures. Dis Colon Rectum 41:190–194
Wexner SD, Hwang YH (2000) Clinical status of laparoscopic bowel surgery for GI malignancy. Oncology 14:1131–1143
Scheidbach H, Schubert D, Hügel O, van den Hoogen A, Rose J, Pross M, Kose D, Köckerling F, Lippert H (2007) Results of laparoscopic surgery for colorectal cancer in palliative intent: short term end points in 331 patients in comparison with procedures in benign indications. Surg Laparosc Endosc Percutan Tech 17:79–82
Stephenson ER, Ilahi O, Koltun WA (1997) Stoma creation through the stoma site: a rapid, safe technique. Dis Colon Rectum 40:112–115
Oliveira L, Reissman P, Nogueras J, Wexner SD (1997) Laparoscopic creation of stomas. Surg Endosc 11:19–23
Hollyoak MA, Lumley J, Stitz RW (1998) Laparoscopic stoma formation for faecal diversion. Br J Surg 85:226–228
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Scheidbach, H., Ptok, H., Schubert, D. et al. Palliative stoma creation: comparison of laparoscopic vs conventional procedures. Langenbecks Arch Surg 394, 371–374 (2009). https://doi.org/10.1007/s00423-007-0220-3
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DOI: https://doi.org/10.1007/s00423-007-0220-3