中低位直肠癌手术预防性肠造口中国专家共识(2022版)

Chinese expert consensus on protective ostomy for mid-low rectal cancer(version 2022)

中低位直肠癌保肛手术比例越来越高,但吻合口漏仍然是术后常见的严重并发症之一,如何降低吻合口漏发生率以及减轻吻合口漏发生后的危害程度,一直是结直肠外科的热点和难点。预防性造口是目前临床上应对上述问题的常用方法,但由此带来的过度造口、造口相关并发症等问题也困扰临床医务工作者。本共识就预防性造口使用指征、临床价值、手术技巧、并发症防治、还纳及造口期护理等相关问题进行阐述,旨在为我国中低位直肠癌手术行预防性肠造口的临床实践提供指导意见。

The rate of sphincter-preserving surgery for mid-low rectal cancer is increasing,but anastomotic leakage remains to be one of the common serious complications after operation.How to reduce the morbility and mortality of anastomotic leakage is always a hot and difficult point in colorectal surgery.Protective ostomy is a common method to deal with the above problems in clinical practice.However,some problems such as inappropriate stoma and stoma-related complications etc.become the current clinical challenges.The purpose of this consensus focusing on indication of ostomy,clinical value,ostomy skills,prevention of stoma complications,reversion of stoma and stoma nursing aims to provide guidance for the clinical practice of protective ostomy in the operation of mid-low rectal cancer in China.