末端回肠外置造口在低位直肠癌手术中的应用

The application of terminal ileostomy in low rectal cancer operation

目的探讨末端回肠造口在低位直肠癌手术中的临床价值。方法回顾性分析16例低位直肠癌前切除术中加行末端回肠外置造口术防治吻合口漏的临床资料。结果 16例均经直肠癌低位前切除术切除病灶一期吻合并加行末端回肠外置造口术。术后未发生吻合口漏。2个月后二期手术回纳回肠造口,回纳前3例出现直肠吻合口狭窄,所有病人如期实施造口回纳,未出现并发症。结论末端回肠外置造口制作和回纳简单,手术并发症少,可有效预防和治疗直肠癌术后吻合口漏,尤其在高龄、全身情况较差、有伴发病、手术操作难度大等不利于低位吻合病人中有较好的临床推广价值。

Objective To investigate the clinically applied value of terminal ileostomy in low rectal cancer operation. Methods We retrospectively analyzed clinical data of 16 cases of rectal cancer, who accepted low anterior resection plus terminal ileostomy to prevent and cure anastomotic leakage. Results All the 16 cases accepted primary resection and anastomosis plus terminal ileostomy, and no stomal leak was observed. Two month later, the patients accepted second-stage colostomy apothesis. Three eases showed low rectum anastomotie stenosis before the apothesis detected by direct rectum examination and enteroscopy,and were cured by balloon dilatation. All the patients were reduced successfully, and no complication was observed. Conclusion Terminal ileostomy was a simple surgical procedure with less complication,and could prevent and treat stomal leak after rectal cancer operation effectively,especially in the old patients with multiple concomitant diseases.