达芬奇机器人保肛手术中末端回肠保护性造口的效果分析  

Analysis in efficiency of protective colostomy of terminal ileum in anus-preserving surgery with Leonardo′s robot

作　　者：姚莉倩 王俐稔[1] YAO Liqian;WANG Liren(Department of Gastrointestinal Surgery,Huashan Hospital Affiliated to Fudan University,Shanghai,200040)

机构地区：[1]复旦大学附属华山医院胃肠外科,上海200040

出　　处：《实用临床医药杂志》2021年第1期26-28,共3页Journal of Clinical Medicine in Practice

基　　金：上海市科委“一带一路”青年科学家交流国际合作项目(17410742100)。

摘　　要：目的观察保护性造口在加速康复外科理念指导下达芬奇机器人保肛手术中的应用效果。方法选取本院直肠癌患者63例,根据是否行末端回肠保护性造口分为造口组31例与非造口组32例,比较2组围术期指标、肠功能恢复情况以及并发症发生率。结果与非造口组比较,造口组手术时间延长,术中出血量增加,术后住院时间、术后首次化疗时间均明显缩短,差异有统计学意义(P<0.05);造口组首次通气时间及首次进食时间均早于非造口组,差异有统计学意义(P<0.05);造口组并发症发生率为9.68%,低于非造口组的18.75%,差异无统计学意义(P>0.05)。结论加速康复外科理念指导下的达芬奇机器人保肛手术中应用保护性造口可有效缩短患者住院时间,促进术后肠功能恢复,且并发症较少。Objective To observe the effect of protective colostomy in anus-preserving surgery with Leonardo′s robot under guidance of the concept of fast-track surgery.Methods A total of 63 patients with rectal cancer were divided into stoma group(n=31)and non-stoma group(n=32)according to implementation of protective colostomy of terminal ileum.The perioperative indicators,the recovery of intestinal function and the incidence of complications were compared between the two groups.Results The operation time was longer and blood loss was more in the stoma group than those in the non-stoma group,while the postoperative hospital stay and the first time to postoperative chemotherapy were significantly shorter than those in the non-stoma group(P<0.05).The first ventilation time and the first eating time in the stoma group were significantly earlier than those in the non-stoma group(P<0.05).The incidence of complications in the stoma group was 9.68%,which was significantly lower than 18.75%in the non-stoma group(P>0.05).Conclusion Protective colostomy in anus-preserving surgery with Leonardo′s robot under guidance of the concept of fast-track surgery can effectively shorten the hospital stay of patients and promote the recovery of postoperative intestinal function with fewer complications.

关 键 词：保肛手术 保护性结肠造口术 加速康复外科理念 达芬奇机器人 肠功能 

分 类 号：R574.8[医药卫生—消化系统] R615[医药卫生—内科学]