免回纳回肠造口对直肠吻合口狭窄的影响

Effect of ileostomy with no need of reversal on anastomotic stenosis

目的探讨免回纳回肠造口对腹腔镜直肠癌Dixon术后吻合口狭窄的影响。方法回顾性分析41例行腹腔镜直肠癌Dixon术患者的临床资料。其中,21例行免回纳回肠造口(A组),20例行襻式回肠造瘘(B组)。观察两组患者术后吻合口狭窄及其他并发症的发生情况。结果 A组吻合口狭窄发生率低于B组(4.8%vs.30.0%)(P<0.05),两组吻合口瘘发生率差异无统计学意义。与B组相比,A组二次手术率降低(P<0.01),但术后恢复通气时间延迟(P<0.05)。结论免回纳回肠造口可以减少腹腔镜直肠癌Dixon术后吻合口狭窄的发生率。

Objective To investigate the effect of ileostomy with no need of reversal on anastomotic stenosis after laparoscopic resection for rectal cancer.Methods The data of 41 patients undergoing laparoscopic resection for rectal cancer were retrospectively analyzed,of whom 21 cases accepted ileostomy with no need of reversal（group A）and 20 cases accepted loop ileostomy（group B）.The incidences of anastomotic stenosis and other postoperative complications were observed.Results The incidence rate of anastomotic stenosis was lower in group A than that in group B（4.8% vs.30.0%）（P〈0.05）.There was no significant deference in the incidence rate of anastomotic leakage between two groups.Compared with group B,the reoperation rate of group A was decreased（P〈0.01）and postoperative exhaust time was delayed（P〈0.05）.Conclusion Ileostomy with no need of reversal can reduce the incidence of anastomotic stenosis after laparoscopic resection for rectal cancer.