腹膜外结肠造口在腹腔镜直肠癌Miles术中的临床应用

Extraperitoneal Colostomy Used in Laparoscopic Miles Procedure for Rectal Carcinoma：Clinical Application

为探讨腹膜外结肠造口在腹腔镜直肠癌Miles术中的应用价值，回顾我科于2007年6月至2013年6月完成的102例腹腔镜直肠癌Miles手术患者资料。根据肠造口方式不同分为观察组（腹膜外结肠造口组，57例）和对照组（腹膜内结肠造口组，45例），对比分析两组患者术后造口恢复情况。结果显示，观察组造口旁疝发生率（3．5％）明显低于对照组（17．8％），P〈0．05；两组造口回缩、造口狭窄、黏膜脱垂、造口坏死发生率比较差异均无统计学意义，P〉0．05。结果表明，腹膜外结肠造口可降低腹腔镜Miles术后造口旁疝的发生率，值得临床推广应用。

In order to evaluate the value of extraperitoneal colostomy used in laparoscopic Miles procedure for rectal carcinoma,authors retrospectively reviewed the data of 120 patients who had received laparoscopic Miles procedure for their rectal carcinoma from June 2007 to June 2013 yr., according to the different ways of enterostomy divided them into observation group（57 cases received extraperitoneal colostomy） and control group（45 cases,intraperitoneal colostomy）,then compared and analysis the recovery status after neostomy between both groups. As results, in observation group the incidence of parastomal hernia was singnificantly lower than that in control group（3.5% vs 17.8%, P 〈0.05）,but in stoma recession,stoma stenosis,mucosa prolapse and the incidence of stoma necrosis there was no statistical difference between both groups（ P 〉0.05）.Results show that extraperitoneal colostomy can reduce the incidence of parastomal hernia after laparoscopic Miles procedure,thus is worthy to be popularized to use clinically.