改良皮下缝合预防性回肠造口对低位直肠癌术后快速康复的影响

Effect of Preventive Ileostomy with Improved Subcutaneous Suture on the Postoperative Rapid Recovery of Low Rectal Cancer

目的:探讨改良皮下缝合预防性回肠造口对腹腔镜低位直肠癌根治术后快速康复的影响。方法:回顾性分析2017年8月-2019年12月在笔者所在医院收治的83例腹腔镜低位直肠癌根治术行预防性回肠造口患者的临床资料,依据回肠造口的不同术式,分为传统腹直肌前鞘缝合固定组(传统组,n=40)和改良皮下缝合固定组(改良组,n=43),比较分析两组患者术中及术后相关指标、回肠造口并发症发生率。结果:两组患者手术均顺利完成,未出现术后严重并发症。两组手术时间、造口排气时间比较差异无统计学意义(P>0.05)。改良组住院时间短于传统组,更换造口底盘次数及造口材料费用少于传统组,差异均有统计学意义(P<0.05);改良组患者满意度评分高于传统组,差异有统计学意义(P<0.05);改良组术后回肠造口并发症发生率为6.97%,低于传统组的32.50%,差异有统计学意义(P<0.05)。结论:相比于预防性回肠造口传统术式,改良皮下缝合术式可降低腹腔镜低位直肠癌根治术后回肠造口并发症发生率,缩短住院时间,促进术后快速康复,提高患者生活质量。

Objective:To explore the effect of preventive ileostomy with improved subcutaneous suture on the postoperative rapid recovery of laparoscopic radical operation for low rectal cancer.Method:The clinical data of 83 patients with laparoscopic radical operation of low rectal cancer who underwent preventive ileostomy from August 2017 to December 2019 were analyzed retrospectively.According to the different types of ileostomy,they were divided into the traditional rectus abdominis anterior sheath suture fixation group (traditional group,n=40) and the improved subcutaneous suture fixation group (improved group,n=43).The general clinical data,intraoperative and postoperative indexes,and the incidence of ileostomy complications were compared between the two groups.Result:The operation was successfully completed in both groups without serious postoperative complications.There were no significant differences of the operation time and ileostomy exhaust time between the two groups (P>0.05).The hospitalization time of the improved group was shorter than that of the traditional group,the times of changing the stoma chassis and the cost of stoma materials were less than those of the traditional group,the differences were statistically significant (P<0.05).The satisfaction score of the improved group was higher than that of the traditional group,the difference was statistically significant (P<0.05).The incidence of ileostomy complications in the improved group was 6.97%,which was lower than 32.50% of the traditional group,the difference was statistically significant (P<0.05).Conclusion:Comparing with the traditional preventive ileostomy,the improved subcutaneous suture can reduce the incidence of postoperative complications of ileostomy for laparoscopic radical operation of low rectal cancer,shorten hospital stay,promote rapid postoperative recovery,and improve the quality of life of patients.