腹腔镜下腹膜外造瘘与腹膜内造瘘的对照研究及腹膜外造瘘的技巧  

Comparison of laparoscopic extraperitoneal colostomy and peritoneal colostomy and the technique of laparoscopic extraperitoneal colostomy

作　　者：刘浩 牛露伟 白津 李朝阳 张彬 符炜 王凯 

机构地区：[1]徐州医科大学附属医院胃肠外科,江苏徐州221002 [2]江苏省肿瘤生物治疗研究所,江苏徐州221002

出　　处：《徐州医学院学报》2016年第11期722-724,共3页Acta Academiae Medicinae Xuzhou

基　　金：国家自然科学基金面上项目（81472663）

摘　　要：目的总结腹腔镜下腹膜外造瘘的优势及腹膜外造瘘的技术要点。方法回顾性研究徐州医科大学附属医院胃肠外科2010年1月至2014年1月间共95例行腹腔镜Miles手术或Hartman手术患者的临床资料，其中中低位直肠癌77例，肛管癌14例，高位直肠癌4例。腹膜外造瘘70例（A组），腹膜内造瘘25例（B组），随访时间2年，比较两种造瘘方式中出现造瘘旁疝等并发症的发生率。结果患者均在腹腔镜辅助下完成直肠肿瘤切除及永久性乙状结肠造瘘，无中转开腹，无手术死亡。腹膜外造瘘1例出现造瘘口旁疝，腹膜内造瘘4例出现造瘘口旁疝，差异有统计学意义（P〈0．05）。结论腹腔镜下腹膜外乙状结肠造瘘简单易行，并可减少术后造瘘口旁疝的发生率。Objective To summarize the advantages of laparoscopic extraperitoneal colostomy and the key points of peritoneal colostomy. Methods Data were retrospectively collected from 95 patients who were admitted into our hospital from January 2010 to January 2014 and underwent laparoscopic Miles or Hartman surgery. There were 77 cases of low rectal cancer, 14 cases of canal cancer, and 4 cases of rectal cancer. A total of 70 patients received extraperitoneal colostomy （ Group A）, while 25 patients underwent peritoneal colostomy （ Group B）, and all of them were followed up for 2 years. Then, both groups were compared for the incidence of complications. Results All the patients underwent laparo- scopic resection of colorectal neoplasms, without transfering to laparotomy or operative death. Furthermore, there were 1 and 4 patients with parastomal hernia in Groups A and B, respectively, which were statistically different （ P 〈 0.05 ）. Conclusions Laparoscopic extraperitoneal colostomy is a simple approach and can reduce the incidence of postoperative parastomal hernia.

关 键 词：造瘘口 腹膜外途径 腹腔镜 造瘘口旁疝 

分 类 号：R73[医药卫生—肿瘤]