To compare the clinical outcome of two different sigmoidostomy in laparoscopic abdominoperineal resection (LAPR) of rectal cancer.

From May 2017 to March 2020, the clinical data of 81 patients underwent LAPR were analyzed retrospectively, who were divided into the extraperitoneal group (extraperitoneal stoma, 36 cases), and the intraperitoneal group (intraperitoneal stoma, 45 cases). Statistical analysis were performed by using SPSS23.0 software. The perioperative indicators were expressed as (±s), and were examined by using independent t test. Defecation function, Kirwan incontinence classification for postoperative complications were analyzed by using χ² test or the rank sum test. A P value of <0.05 was considered as statistically significant difference.

The operation time, first postoperative exhaust, defecation time, the time of postoperative hospitalization and intraoperative bleeding in the extraperitoneal group were less than those in the intraperitoneal group respectively (P<0.05). The excellent rate of 80.6% of postoperative defecation in the extraperitoneal group was higher than 60.0% in the intraperitoneal group (P<0.05). The Kirwan incontinence grade in the extraperitoneal group was lighter than that in the intraperitoneal group (P<0.05). The incidence of 8.3% of postoperative complications was lower in the extraperitoneal group than 26.7% in the intraperitoneal group (P<0.05).

Compared with intraperitoneal sigmoidostomy, extraperitoneal sigmoidostomy is more safe and effective with rapid postoperative rehabilitation, reduced the complications and improved control of defecation.