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Session: New Technology Abstract Session (NON CME)

NT3 - Laparoscopic Extraperitoneal Colostomy Anterior To Posterior Sheath Of Rectus Abdominis-Transversus Abdominis To Prevent Parastomal Hernia

Monday, May 12, 2025
4:05 PM – 4:15 PM PT
Location: Ballroom 6C-F, Upper Level

    Presenting Author(s)

  • jian Qiu, Medical doctor

    Chief physician
    anorectal surgery department
    Xi'an, Shaanxi, China (People's Republic)

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • ZL

    Zeyu Li, Medical docter

    Docter
    Shaanxi provincial people's hospital
    Xi'an, Shaanxi, China (People's Republic)

    Disclosure information not submitted.

  • BW

    Ben Wang, Medical master

    Docter
    Shaanxi provincial people's hospital
    Xi'an, Shaanxi, China (People's Republic)

    Disclosure information not submitted.

All of the relevant financial relationships listed below have been mitigated.
jian Qiu, Medical doctor: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: Parastomal hernia is an inevitable complication for patients with low rectal cancer undergoing abdominal perineal resection (APR). We used the technique of laparoscopic total extraperitoneal (TEP) groin hernia repair to produce abdominal wall stomy tunnel, which is anterior to posterior rectus abdominis sheath-transversus abdominis. This myofascial flap posterior to stomy colon can serve as autobiologic materials to protect the defect of the abdominal wall of the stoma. With laparoscopy, we can create adequate space with precise visualization while avoiding damage to the retrorectus sheath. In this study, we explore the effect of laparoscopic extraperitoneal colostomy anterior to posterior sheath of rectus abdominis-transversus abdominis for the prevention of parastomal hernia after abdominoperineal radical resection (APR) for rectal malignant tumor.

Methods/Interventions: This study is a prospective cohort study. From June 2021 to present, in the first department of general surgery of Shaanxi Provincial People's Hospital, patients with low rectal cancer underwent laparoscopic APR combine with extraperitoneal colostomy anterior to posterior sheath of rectus abdominis-transversus abdominis were enrolled. The clinical data and postoperative CT images of patients were collected to analyze the incidence of surgical complication and parastomal hernia.

Results/Outcomes: 12 cases of patient were enrolled, including 7 males and 5 females, with a median age of 67.3 (11.5) years [M (QR)] (ranging from 55 to 81 years). The median operation time was 235(47.5) min [M (QR)] (ranging from 190 to 325 min), the median stoma operation time was 25.1(10.5) min [M (QR)] (ranging from 21 to 37 min), the median bleeding volume was 40(35) ml [M (QR)] (ranging from 10 to 80 min). All patients were cured and discharged without surgery-related complications. The median follow-up time was 576(105) days [M (QR)] (ranging from 86 to 1219 days). After physical examination and abdominal CT follow-up, no parastomal hernia occurred in the 12 patients up to this report.

Conclusion/Discussion: A method of laparoscopic extraperitoneal colostomy anterior to posterior sheath of rectus abdominis-transversus abdominis was established. Permanent stoma can be completed with this method safely. It may have a outstanding preventive effect on the occurrence of parastomal hernia.