腔镜下管状吻合器在Mile’s术经侧腹膜结肠造口的临床应用价值

Clinical application value of laparoscopic tubular anastomat in Mile’s abdominoperineal colostomy

目的探讨腔镜下管状吻合器在Mile’s术经侧腹膜结肠造口的临床应用价值。方法60例低位直肠癌患者随机分为观察组和对照组,每组30例。观察组采用腔镜下Mile’s术,结肠造口经侧腹膜采用管状吻合器完成,对照组采用常规开腹手术操作,结肠造口经腹腔采用手工缝合的方法完成,对2组患者围手术期相关指标及造口并发症的发生率进行比较。结果观察组术中出血量、手术时间、胃肠功能恢复时间、淋巴结清扫例数、术后住院天数及住院总费用等围手术指标优于对照组,差异均有统计学意义(P<0.05)。术后随访1年,2组生活质量评分指标进行比较,差异有统计学意义(P<0.05);2组患者术后肠造口常见并发症进行比较,差异有统计学意义(P<0.05)。结论采用管状吻合器经侧腹膜进行结肠造口具有操作简单,并发症少,易于护理等优势。可以明显改善患者术后生活质量。

Objective To investigate the clinical application value of laparoscopic tubular anastomat in Mile’s abdominoperineal colostomy.Methods A total of 60 patients with low rectal cancer were randomly divided into observation group(n=30)and control group(n=30).The patients in observation group were treated by laparoscopic Mile’s operation,and the colostomy was completed by tubular anastomat through the side peritoneum.However,the patients in control group were treated by conventional laparotomy operation,the colostomy was completed by manual suture.The perioperative related indexes and the incidence of colostomy complications were observed and compared between the two groups.Results The perioperative indexes including intraoperative blood loss,operation time,gastrointestinal function recovery time,lymph node cleaning numbers,postoperative hospitalization days and total hospitalization expenses in observation group were superior to those in control group(P<0.05).After 1-year follow up,there were significant differences in life quality scores between the two groups(P<0.05).Moreover there was significant difference in the incidence rate of common complications after operation between the two groups(P<0.05).Conclusion The laparoscopic tubular anastomat in Mile’s abdominoperineal colostomy has the advantages of simple operation,less complications and easy to be cared,which can significantly improve the life quality of patients after surgery.