腹膜外隧道式造口在腹腔镜直肠癌根治术中的应用体会  

The application experience of extraperitoneal tunnel-colostomy in laparoscopic radical resection of rectal carcinoma

作　　者：张成才[1] 刘志民[1] 徐其佐[1] 石光锋 吴建林[1] 祝林[1] 曹策[1] 

机构地区：[1]淄博市中心医院淄博市腹腔镜工程技术中心,山东淄博255036

出　　处：《腹腔镜外科杂志》2015年第4期277-279,共3页Journal of Laparoscopic Surgery

摘　　要：目的：探讨腹膜外隧道式造口在腹腔镜直肠癌根治术（Miles）中的临床应用价值。方法：将2006年7月至2013年7月为60例需行腹腔镜辅助腹会阴联合切除的低位直肠癌患者随机分为腹膜内造口组（腹膜内组）与腹膜外隧道式造口组（腹膜外组）,术后随访6～12个月,中位时间9个月;对比两组手术时间及早期、后期并发症情况。结果：60例手术均获成功。两组手术时间、早期并发症差异无统计学意义（P〉0.05）,腹膜外组患者造口水肿率明显高于腹膜内组,差异有统计学意义（P〈0.05）;后期并发症发生率腹膜内组高于腹膜外组,差异有统计学意义（P〈0.05）。结论：腹膜外隧道式造口后期造口并发症明显少于腹膜内造口,具有一定的临床应用价值。Objective：To investigate the clinical application value of extraperitoneal tunnel-colostomy in laparoscopic radical resection of rectal carcinoma. Methods：Sixty patients with low rectal cancer undergoing laparoscopie-assisted abdominoperineal resection from Jul. 2006 to Jul. 2013 were retrospectively enrolled in the study and randomly divided into extraperitoneal tunnel-colostomy （EPC） group and internal peritoneal colostomy （IPC） group. Follow-up period was 6-12 （median,9） months. Operation time,postoperative early and late complications were compared between the two groups. Results：The sixty operations were successfully completed. There were no statistically significant differences between EPC group and IPC group in operation time and early postoperative complica- tions （ P 〉 0.05 ）. The incidence of stoma edema was significantly higher in EPC group vs. IPC group, and the difference was statistically significant （ P 〈 0.05 ）. Compared with EPC group, the incidence of postoperative late complication was higher in IPC group （ P 〈 0. 05）. Conclusions ： EPC is of value in clinic with lower incidence of late complications as compared to IPC.

关 键 词：直肠肿瘤 低位 腹腔镜检查 腹膜外隧道式造口 腹膜内造口 

分 类 号：R735.37[医药卫生—肿瘤]