Scheidbach H, Ptok H, Schubert D, Kose D, Hügel O, Gastinger I, Köckerling F, Lippert H
Department of Surgery, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany.
Langenbecks Arch Surg. 2009 Mar;394(2):371-4. doi: 10.1007/s00423-007-0220-3. Epub 2007 Aug 10.
The creation of a stoma is an established therapeutic concept for the palliation of non-resectable rectal carcinomas and advanced tumours infiltrating the pelvis.
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.
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).
Palliative stoma done via laparoscopy had significantly better outcomes in terms of postoperative morbidity and mortality in comparison with the open surgical procedure.
造口术是一种用于缓解不可切除直肠癌和侵犯骨盆的晚期肿瘤的既定治疗理念。
在两项全国性前瞻性多中心研究中，每项研究持续时间相似，比较了腹腔镜与开腹造口术的围手术期过程和术后短期结果。
共有90例患者接受了姑息性腹腔镜造口术；550例患者通过开腹手术造口。尽管差异不显著，但开放手术后的术中并发症发生率低于腹腔镜手术后（2.7%对5.6%；p = 0.15）。然而，在总体（30.9%对15.6%；p = 0.003）以及特定的术后并发症方面（13.8%对5.6%；p = 0.029），腹腔镜手术方法具有显著优势。此外，腹腔镜组的死亡率也显著更低（4.4%对14.0%；p = 0.011）。
与开放手术相比，腹腔镜姑息性造口术在术后发病率和死亡率方面具有显著更好的结果。
