B型缝合法回肠造口术的临床应用

Clinical application of ileostomy with type B suture

目的评价B型缝合法回肠造口术的安全性与有效性。方法回顾性分析204例腹腔镜低位直肠前切除术联合保护性回肠造口患者的临床资料,根据造口方式不同分为B型缝合法造口组(n=67)和传统法造口组(n=137)。结果与传统造口组相比,B型缝合法造口组在总手术时间[(164±26)min比(172±24)min,t=2.229,P=0.027]、造口时间[(12.7±2.3)min比(14.8±2.2)min,t=-6.565,P<0.001]、出血量[(57±20)ml比(69±31)ml,t=-2.797,P=0.006]、术后住院时间[(10.2±1.9)d比(11.8±2.3)d,t=-4.851,P<0.001]、取标本切口感染率(0比5.1%,P=0.047)、术后躯体疼痛评分[82(79~84)比78(76~80),Z=-5.805,P<0.001]、造口还纳手术时间[(46±11)min比(51±12)min,t=-2.540,P=0.012]方面差异均有统计学意义(均P<0.05)。结论B型缝合法回肠造口术用于腹腔镜低位直肠癌预防性造口是安全可行的。

Objective To evaluate safety and efficacy of B-type suture method ileostomy.Methods Clinical data from 204 patients undergoing laparoscopic low anterior resection combined with protective ileostomy was analysed.Patients were divided into B-type suture ileostomy group(n=67)and traditional ileostomy group(n=137).Results compared with traditional ileostomy group,B-type suture ileostomy group showed statistically significant differences in total operation time[(164±26)min vs.(172±24)min,t=2.229,P=0.027],ileostomy time[(12.7±2.3)min vs.(14.8±2.2)min,t=-6.565,P<0.001],blood loss[(57±20)ml vs.(69±31)ml,t=-2.797,P=0.006],postoperative hospital stay[(10.2±1.9)d vs.(11.8±2.3)d,t=-4.851,P<0.001],specimen incision infection rate(0 vs.5.1%,P=0.047),postoperative body pain[82(79-84)vs.78(76-80),Z=-5.805,P<0.001],and ileostomy incorporation time[(46±11)min vs.(51±12)min,t=-2.540,P=0.012].Conclusion B-type suture ileostomy for prophylactic ileostomy in laparoscopic low anterior resection for rectal cancer is safe and feasible.