从还纳术中探讨低位直肠癌保肛手术中预防性造口的选择

Selection of predictive neostomy in anus preserving operation for patients with low rectal cancer

目的比较回肠造口还纳术与横结肠造口还纳术的优缺点。方法回顾性分析2012年1月至2014年12月收治的66例因低位直肠癌保肛手术并预防性造口术后行造口还纳术患者的临床资料,比较回肠造口还纳术与横结肠造口还纳术两组的差异。结果两组术中出血量差异无统计学意义(P>0.05);在还纳时限、还纳手术时间、术后首次排气时间、术后首次排便时间、进食流质时间、还纳术后并发症、术后住院天数、治疗费用方面,回肠造口还纳组均优于横结肠造口还纳组,两组差异均有统计学意义(P<0.05)。结论回肠造口还纳术术后恢复快,更经济、安全,在低位直肠癌保肛手术需要预防性造口时,优先考虑预防性回肠造口术。

Objective To compare the advantages and disadvantages of ileostomy and transverse colostomy.Methods A retrospective study was carried out to analyze the clinical data of 66 patients undergoing anus saving surgery for the treatment of low rectal cancer between January 2012 and December 2014. The differences between surgery of ileostomy closure and transverse colostomy closure were analyzed. Results The differences of blood loss during operation in these two groups have no statistical significance（ P〉 0. 05）. In the aspects of duration of surgery,the operation time,the first aerofluxus after operation,the first cacation after operation,the time of eating fluids,postoperative complication,hospitalization days after operation,cost for treatment,the ileostomy closure all performed better than the transverse colostomy closure,and the differences in these aspects all have statistical significance（ P 〈0. 05）. Conclusions Given the advantages of fast recovery,economy and safety in ileostomy closure surgery,ileostomy should be considered at first in the anal-saving surgery for low rectal cancer.