自制吻合环复合装置保护性回肠造口对直肠癌手术成功及吻合口瘘发生的影响分析  

Effects of Self-made Compound Anastomotic Ring Device for Protective Ileostomy on Surgical Success and Occurrence of Anastomotic Leakage in Rectal Cancer

作　　者：王桂新[1] 袁春华[1] 那洁[1] WANG Guixin;YUAN Chunhua;NA Jie(The First Hospital of Jilin University,Changchun,130061)

机构地区：[1]吉林大学第一医院,130061

出　　处：《实用癌症杂志》2020年第8期1306-1308,1322,共4页The Practical Journal of Cancer

摘　　要：目的探讨自制吻合环复合装置应用于直肠癌患者术中保护性会肠造口的临床效果。方法回顾性分析68例直肠癌手术患者临床资料,行传统回肠造口术者纳入对照组(n=31),借助自制吻合环复合装置行回肠造口术者纳入吻合环组(n=37)。比较两组围术期基本指标及近期并发症发生情况、造口皮肤情况[造口皮肤工具(OST)]、生活质量[生命质量问卷-结直肠癌38(QLQ-CR38)]差异。结果两组手术成功率、手术时间比较均无统计学意义(P>0.05),而吻合环组造口操作时间明显长于对照组,住院时间、治疗费用则明显优于对照组(P<0.05)。术后1周内,两组吻合口瘘、肠梗阻、切口感染发生率比较均无统计学意义(P>0.05),而吻合环组造口脱垂/回缩、造口狭窄发生率均明显低于对照组(P<0.05)。术后1周时,吻合环组OST明显高于对照组,而QLQ-CR38各维度评分及总分均明显低于对照组(P<0.05)。结论自制吻合环复合装置能有效降低直肠癌手术保护性回肠造口引起的造口相关并发症发生风险,有利于促进患者预后康复。Objective To explore the clinical effects of self-made compound anastomotic ring device in the intraoperative protective ileostomy of patients with rectal cancer.Methods The clinical data of 68 patients with rectal cancer surgery were retrospectively analyzed.The patients with conventional ileostomy were included in the control group(n=31),and the patients with self-made compound anastomotic ring device for ileostomy were included in anastomotic ring group(n=37).The perioperative basic indexes and occurrence of recent complications,stoma skin condition[ostomy skin tool(OST)]and quality of life[quality of life questionnaire-colorectal cancer 38(QLQ-CR38)]were compared between the two groups.Results There were no significant differences in the surgical success rate and operative time between the two groups(P>0.05),and the stoma operation time in anastomotic ring group was significantly longer than that in control group,and the hospital stay and treatment cost were significantly better than those in the control group(P<0.05).Within 1 w after operation,there were no significant differences in the incidence rates of anastomotic leakage,intestinal obstruction and incision infection between the 2 groups(P>0.05),and the incidence rates of stoma prolapse/retraction and stoma stenosis in anastomotic ring group were obviously lower than those in control group(P<0.05).At 1 w after operation,the OST in anastomotic ring group was significantly higher than that in the control group,and the scores of dimensions and total score of QLQ-CR38 were significantly lower than those in the control group(P<0.05).Conclusion Self-made compound anastomotic ring device can effectively reduce the risk of stoma-related complications caused by protective ileostomy of rectal cancer surgery,and it is conducive to the prognosis and rehabilitation of patients.

关 键 词：自制吻合环复合装置 保护性回肠造口 直肠癌 吻合口瘘 

分 类 号：R735.37[医药卫生—肿瘤]