腹腔镜直肠癌低位前切除术中应用支架法肠道转流术与临时性回肠造口术的临床效果对比

Comparison of clinical effects of a novel stent assisted intestinal bypass and temporary loop ileostomy in laparoscopic low anterior resection of rectal cancer

目的:对比在腹腔镜直肠癌低位前切除术中应用支架法肠道转流术与临时性回肠造口术的临床应用价值。方法:回顾性分析2020年1月至2022年1月宁波大学附属第一医院行腹腔镜直肠癌低位前切除术的57例患者的临床资料,根据回肠改道方式的不同分为肠道转流组36例和回肠造口组21例。结果:两组患者均顺利完成手术,在术后肠道功能恢复、术后并发症发生率方面差异均无统计学意义(均P>0.05)。术后3个月肠道转流组的血清白蛋白、前白蛋白、血红蛋白水平均高于回肠造口组,差异均有统计学意义[(40.5±2.3)g/L比(38.1±2.6)g/L、(26.4±2.7)mg/dl比(24.5±2.0)mg/dl、(137.6±5.9)g/L比(134.0±7.0)g/L,t=3.605、2.743、2.085,均P<0.05]。肠道转流组的治疗总费用也明显低于回肠造口组[(57100±7500)元比(69300±9100)元,t=-5.477,P<0.05]。结论:支架法肠道转流术应用于腹腔镜直肠癌低位前切除后预防吻合口漏相较于传统的回肠造口术在减少创伤、降低费用、改善患者的营养状况上具有一定的优势。

ObjectiveTo compare the clinical value of stent assisted intestinal bypass and temporary loop ileostomy in laparoscopic low anterior resection of rectal cancer.MethodIn this retrospective analysis,57 patients undergoing laparoscopic low anterior resection for rectal cancer in the First Affiliated Hospital of Ningbo University from Jan 2020 to Jan 2022 were divided into intestinal bypass group(36 cases)and loop ileostomy group(21 cases).ResultThere were no significant differences in postoperative GI function recovery and postoperative complication rate between the two groups(all P>0.05).The levels of albumin,prealbumin and hemoglobin in the intestinal bypass group were better than those in the ileostomy group when evaluated on 3rd months after operation[(40.5±2.3)g/Lvs.(38.1±2.6)g/L、(26.4±2.7)mg/dl vs.(24.5±2.0)mg/dl、(137.6±5.9)g/L vs.(134.0±7.0)g/L,t=3.605、2.743、2.085,all P<0.05].Hospital expenses of the intestinal bypass group was lower[(571000±7500)yuanvs.(69300±9100)yuan,t=-5.477,P<0.05].ConclusionCompared with traditional ileostomy,the stent assisted intestinal bypass reduces trauma with lower expenses and improves patients'status after laparoscopic low anterior resection for rectal cancer.