腹腔镜辅助与传统开腹回肠袢式造口还纳术的对比研究

Comparative study of the efficacy between laparoscopic loop ileostomy reversal and standard loop ileostomy reversal

目的:对比腹腔镜辅助与传统开腹回肠袢式造口还纳术,评估腹腔镜技术在回肠袢式造口还纳术中应用的优劣。方法:对本院接受腹腔镜辅助(n=25)和常规开腹手术(n=41)的回肠袢式造口患者的基线资料、术中出血量、手术时间、术后住院天数、术后并发症等进行统计学分析。结果:2组患者的基线临床资料无统计学差异,腹腔镜辅助组术后总并发症发生率4%(1/25),为顽固性腹水1例,无切口感染及肠梗阻(0/25);传统手术组顽固性腹水、切口感染和肠梗阻的发生率分别为14.63%(6/41)、4.88%(2/41)、9.76%(4/41)。腹腔镜辅助组手术时间显著长于传统手术组(P<0.05)。术中出血量及术后住院天数,2组间无显著性差异。结论:腹腔镜辅助回肠袢式造口还纳术是安全的微创手术方式,有减少术后并发症的趋势。

Objective：To compare the efficacy of laparoscopic assisted loop ileostomy reversal with standard loop ileostomy reversal.Methods：Sixty six patients with loop ileostomy were divided into two groups.They were treated with laparoscopic assisted（25 cases）or traditional laparotomy approach surgery（41 cases）.Procedure time,blood loss,average hospitalization time after operation and post-operative morbidity were measured.Results：There was no difference in the clinical characteristic in two groups.Total postoperative complication rate was 4%（1/25 case of intractable ascites）without major post-operative morbidity including wound infection（0/25）and intestinal obstruction（0/25）in laparoscopic assisted group.The corresponding complication rates were14.63%（6/41）,4.88%（2/41）and 9.76%（4/41）,respectively in traditional surgery group（P〈0.05）.The procedure time of laparoscopic assisted group was significantly longer than that of the traditional surgery group（P〈0.05）.There were no differences in blood loss and average hospitalization time after operation between the two groups.Conclusion：Laparoscopic loop ileostomy reversal is a safe procedure.