腹腔镜肠造口术应用于梗阻性结直肠癌患者临床价值分析

Clinical value of laparoscopic enterostomy in patients with obstructive colorectal cancer

目的探讨腹腔镜肠造口术在梗阻性结直肠癌患者中的临床价值。方法回顾性分析17例行腹腔镜肠造口术治疗的梗阻性结直肠癌患者的临床资料。结果17例患者均顺利实施腹腔镜造口手术,未中转行开腹手术,其中行乙状结肠双腔造口1例,横结肠双腔造口7例,回肠双腔造口9例。术后安返病房,无一例患者转重症医学科,未出现围手术期死亡病例。患者平均手术时间为(75±15)min,术中出血量为2~20 ml,平均术中出血量为10 ml。术后留置胃管时间为1~2 d,留置尿管时间为1~2 d,下床活动时间为1~2 d。术后1~2 d,肛袋膨胀后或有肠内容物流出后可拔除胃管,少量流质饮食。17例患者术后随访3个月,均未出现死亡,未出现切口感染及切口疝,未发生严重并发症。结论腹腔镜肠造口术应用于梗阻性结直肠癌患者创伤小、并发症少,明显提高了手术安全性,是梗阻性结直肠癌患者首选的造口方式。

Objective To discuss the clinical value of laparoscopic enterostomy in patients with obstructive colorectal cancer.Methods The clinical data of 17 patients with obstructive colorectal cancer undergoing laparoscopic enterostomy were retrospectively analyzed.Results 17 patients were successfully performed laparoscopic stoma,not converted to open surgery,including 1 case of sigmoid double lumen stoma,7 cases of transverse double lumen stoma,9 cases of ileal double lumen stoma.No patient was transferred to intensive care department and no perioperative death occurred.The average surgery time was(75±15)min,the amount of intraoperative hemorrhage was 2-20 ml,and the average amount of intraoperative hemorrhage was 10 ml.The time of indwelling gastric tube was 1-2 d after surgery,the time of indwelling urinary tube was 1-2 d,and the time of off-bed activity was 1-2 d.1-2 d after surgery,the gastric tube can be removed and a small amount of liquid diet can be removed after the anal bag is inflated or after the intestinal contents have flowed out.All the 17 patients were followed up for 3 months without death,infection,hernia or serious complications.Conclusion Laparoscopic enterostomy has the advantages of less trauma and fewer complications,which significantly improves the safety of surgery and is the preferred ostomy method for patients with obstructive colorectal cancer.