ObjectiveTo contrastive the clinical results of intraperitoneal sigmoid colostomy and extraperitoneal sigmoid colostomy in abdominal perineal resection. MethodsThe clinical data of 172 patients who underwent abdominal perineal resection from March 2010 to March 2014 were retrospectively analyzed.Sixty cases were performed the intraperitoneal sigmoid colostomy (intraperitoneal group), seventy-six cases were performed the extraperitoneal sigmoid colostomy (extraperitoneal group), and thirty-six cases were performed the functional exercise after extraperitoneal sigmoid colostomy (functional exercise group). The operation situation, postoperative complications, and colostomy function of three groups of patients were compared. Results①Operation situation: The colostomy location selection, operative time, intraoperative blood loss, and postoperative hospital stay of the three groups had no statistically significant differences (P > 0.05). The postoperative first exhaust and defecate time of the intraperitoneal group and the functional exercise group were obviously earlier than the extraperitoneal group, the difference had statistical significance (P < 0.05).②The postoperative complications: The postoperative complications rates of the extraperitoneal group and functional exercise group were lower than the intraperitoneal group, had statistically significant difference (P < 0.05), the functional exercise group was lower than the extraperitoneal group, the difference had statistical significance (P < 0.05).③The colostomy function:The patient' proportion that > 30 s of appeared time of defecation signals in the extraperitoneal group was significantly higher than the intraperitoneal group, and the functional exercise group was higher than that in the extraperitoneal group, the difference were statistically significant (P < 0.05). The patient' proportion that > 2 min of autonomous control of defecation to discharge feces time after the bowel signal appears in the extraperitoneal group was significantly higher than the intraperitoneal group, and the functional exercise group was higher than that in the extraperitoneal group, the difference were statistically significant (P < 0.05). Conciusions The intraperitoneal sigmoid colostomy has less colostomy related complications than extraperitoneal sigmoid colostomy in abdominal perineal resection. The control, and defecate ability are better. Postoperative function exercise can further reduce the colostomy complications and improve the function of colostomy.