经结肠双腔造口局部切除闭瘘术的术式探讨

Clinical investigation of closure operation by local resection for double-cavity colonic stoma

目的探讨经结肠双腔造口局部切除闭瘘术的手术方法及注意事项。方法对2009年1月至2012年6月12例结肠双腔造口闭瘘术患者的临床资料进行回顾性分析。结果 12例患者手术时间为1.5～2.0h。术后切口一期愈合10例(83.3%),切口感染2例,均并发吻合口漏,占16.7%;均无腹腔内感染。随访4～36个月,随访率为83.3%(10/12),无再次行造口术的患者,无切口疝(包括2例吻合口漏的患者)等并发症发生。结论经结肠双腔造口局部切除闭瘘术安全可靠,副损伤小。

Objective To explore the operative procedures and notes of closure operation by local resection for double-cavity colonic stoma. Methods Retrospective analyses of clinical data were performed in 12 patients, who had undergone colostomy and closure operation from January 2009 to June 2012. Results The operative time was 1.5 - 2.0 hours. Primary healing was obtained in 10 patients （83.3 % ） after operation. Wound infection occurred in 2 patients （ 16.7% ） , both complicated by anastomotic fistula, and there was no intra-abdominal infection. The patients were followed up for 4 - 36 months, with a follow-up rate of 83.3%. No patients required colostomy once again, and no complications such as incisional hernia were seen （ including 2 anastomotic fistula patients）. Conclusion Double-cavity colostomy closure by local resection is a satisfactory choice for its safety, reliability and minor secondary damage.