Palliative stoma creation: comparison of laparoscopic vs conventional procedures |
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Authors: | H Scheidbach H Ptok D Schubert D Kose O Hügel I Gastinger F K?ckerling and H Lippert |
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Institution: | (1) Department of Surgery, Otto-von-Guericke-University Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Germany;(2) Department of Surgery, Carl-Thiem-Hospital, Thiemstr. 111, 03048 Cottbus, Germany;(3) Institute for Informatics and Biometrics, Otto-von-Guericke-University Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Germany;(4) Department of Surgery and Center for Minimally Invasive Surgery, Hannover Hospital, Roesebeckstr. 15 (Siloah), 30449 Hannover, Germany |
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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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Keywords: | Palliation Colorectal surgery Stoma creation Morbidity Laparoscopic |
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