Miles术中应用管状吻合器行腹膜外结肠造口的临床研究

Clinical study of circular stapler for extraperitoneal colostomy in Miles procedure

目的探讨Miles手术中管状吻合器行腹膜外结肠造口的应用价值。方法回顾性分析2013年1月至2015年1月潍坊市人民医院肛肠外科行Miles永久性腹膜外结肠造口术的60例直肠癌患者的临床资料,按结肠造口方式分为吻合器组28例和手工组32例,随访观察并对比分析两组的手术安全性、造口时间、近远期造口直接相关并发症情况。结果 60例患者手术均获成功,无手术死亡。随访7~24个月,中位随访时间14个月。两组造口的近远期直接相关并发症差异无统计学意义,但吻合器组在造口时间方面有明显的优势。结论 Miles术中应用管状吻合器行腹膜外结肠造口,具有安全、简单、缩短手术时间、不增加手术并发症的优点,值得推广。

Objective To explore the application value of circular stapler in extraperitoneal colostomy during Miles procedure.Methods Retrospective analysis was made to 60 cases that experienced extraperitoneal colostomy with circular stapler from January 2013 to January 2015 in the department of colon and anal surgery of Weifang People＇s Hospital.The cases were divided into circular stapler-assisted group（n=28）and traditional hand-stitched group（n=32）.The safety of surgery,the stoma time,and the short-term and long-term colostomy-related complications were followed-up and analyzed.Results All of the colostomies were successfully completed,and no one death occurred after surgery.All of the cases were followed up for 7to 24months（median 14months）.There was no statistically significant difference in the short-term and long-term colostomy-related complications between the two groups,but the circular stapler-assisted group had a obvious superiority in aspects of the stoma time.Conclusion Extraperitoneal colostomy using circular stapler in Miles procedure is safe and simple,and has shorter stoma time,at the same time,the short-term and long-term colostomy-related complications were not increased.It is worth spreading.