Palliative stoma creation: comparison of laparoscopic vs conventional procedures

Langenbecks Arch Surg. 2009 Mar;394(2):371-4. doi: 10.1007/s00423-007-0220-3. Epub 2007 Aug 10.

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.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Colorectal Neoplasms / pathology
  • Colorectal Neoplasms / surgery*
  • Colostomy / methods*
  • Colostomy / mortality
  • Female
  • Humans
  • Intraoperative Complications / etiology*
  • Intraoperative Complications / mortality
  • Intraoperative Complications / surgery
  • Laparoscopy / methods*
  • Male
  • Neoplasm Invasiveness
  • Palliative Care / methods*
  • Postoperative Complications / etiology*
  • Postoperative Complications / mortality
  • Postoperative Complications / surgery
  • Prospective Studies
  • Quality Control
  • Reoperation
  • Survival Analysis