回肠末端改良自闭式造口术治疗低位直肠癌腹腔镜保肛手术患者的疗效及安全性

Efficacy and safety of modified spontaneously closing terminal ileostomy for the treatment of low rectal cancer patients undergoing laparoscopic anus-preserving surgery

目的探讨回肠末端改良自闭式造口术治疗低位直肠癌腹腔镜保肛手术患者的疗效及安全性。方法选取80例低位直肠癌患者,均接受腹腔镜保肛手术,根据造口方式的不同分为对照组(n=50)和改良组(n=30),对照组患者给予回肠末端袢式造口术,改良组患者给予回肠末端改良自闭式造口术。比较两组患者的术中相关指标、术后相关指标及并发症发生情况。结果两组患者手术时间、造口时间、术中出血量、肠功能恢复时间、首次进食时间比较,差异均无统计学意义(P﹥0.05),改良组患者住院时间明显短于对照组,住院费用明显低于对照组,差异均有统计学意义(P﹤0.01)。两组患者住院期间及远期并发症总发生率比较,差异均无统计学意义(P﹥0.05)。结论回肠末端改良自闭式造口术与回肠末端袢式造口术疗效及安全性均较好,但前者可明显缩短术后住院时间,减轻经济压力。

Objective To explore the efficacy and safety of modified spontaneously closing terminal ileostomy for the treatment of low rectal cancer patients undergoing laparoscopic anus-preserving surgery.Method A total of 80 patients with low rectal cancer were selected,all of whom underwent laparoscopic anus-preserving surgery.They were divided into control group(n=50)and modified group(n=30)based on the different methods of stoma surgery,the control group patients were treated with end loop ileostomy,while the modified group patients were treated with modified spontaneously closing terminal ileostomy.The intraoperative,postoperative,and incidence of complications intraoperative relevant indicators,postoperative relevant indicators,and incidence of complications were compared between two groups.Result There were no statistically significant differences in the surgical time,stoma time,intraoperative blood loss,intestinal function recovery time,and first meal time between the two groups(P>0.05).The hospitalization time of the modified group was significantly shorter than that of the control group,and the hospitalization cost was significantly lower than that of the control group,the differences were statistically significant(P<0.01).There were no significant differences in the incidence of complications during hospitalization and in the long term between the two groups(P>0.05).Conclusion The modified spontaneously closing terminal ileostomy and end loop ileostomy have good efficacy and safety,but the former can significantly shorten postoperative hospitalization time and reduce economic pressure.