预防性回肠造口对低位直肠癌手术吻合口的影响

Influence of Prophylactic Ileostomy on the Stoma in the Surgery for Low Rectal Carcinoma

为探讨预防性回肠造口对低位直肠癌手术吻合口的影响及对吻合口早期管理的方法和价值,回顾性分析2016年1月至2017年10月收治的62例直肠癌患者的临床资料。62例直肠癌患者均行直肠癌根治性切除保肛手术加转流性袢式回肠造口术,于术后3～4周进行术后早期吻合口管理,即行电子肠镜检查,观察直肠吻合口愈合情况,并对不同并发症给予不同方式的治疗。结果显示,至术后6个月仅有1例患者因吻合口狭窄而不能进行造口还纳手术。结果表明,早期肠镜检查应用于低位直肠癌术后吻合口管理中,能早期有效预防、治疗直肠吻合口漏和吻合口狭窄,提高转流性袢式回肠造口还纳率和患者术后生活质量。

In order to investigate the influence of prophylactic ileostomy on the stoma in the surgery for low rectal carcinoma,and to seek for early management method of stoma and evaluate its value,authors retrospectively analyzed the clinical data of 62 rectal carcinoma patients admitted in author＇s hospital from Jan. 2016 to Oct. 2017 yr. who had received anus-saving radical resection and diverted ansiform ileostomy, and at 3-4 weeks after surgery their stoma were early managed, i.e, electro-enteroscopy to inspect stoma healing situation,and according to different complications to treat them.As results, at 6 months after sur- gery only 1 case could not receive restoring surgery due to the stoma stricture.Results show that using ear- ly enteroscopy in postoperative management of stoma can early effectively prevent and cure stoma fistula and stenosis, enhance the restoring rate of the diverted ansiform ileostomy and patients＇ postoperative ouality of life.