12 mm trocar在腹腔镜低位直肠癌根治术后预防性回肠造口中的应用  

Application of 12 mm Trocar in Prophylatic Ileostomy After Laparoscopic Radical Resection for Low Rectal Cancer

作　　者：岳晔玮 张志宇[1] 毛晓俊 马彭[3] Yue Yewei;Zhang Zhiyu;Mao Xiaojun(Department of Gastrointestinal Surgery,Affiliated Danyang Hospital of Nantong University,Danyang 212300,China)

机构地区：[1]南通大学附属丹阳医院胃肠外科,丹阳212300 [2]南通大学医学院,南通22601 [3]南通大学附属医院胃肠外科,南通226001

出　　处：《中国微创外科杂志》2022年第11期869-873,共5页Chinese Journal of Minimally Invasive Surgery

基　　金：镇江市社会发展指导性科技计划项目(FZ2020005)。

摘　　要：目的探讨12 mm trocar在腹腔镜低位直肠癌根治术后预防性回肠造口中的临床应用效果。方法回顾性分析2014年3月~2021年12月我院60例低位直肠癌的临床资料,2018年1月~2021年12月30例应用12 mm trocar行预防性回肠造口为观察组,2014年3月~2017年12月30例常规造口为对照组,观察2组患者造口手术时间、造口手术出血量、术后24 h造口处疼痛数字评分(Numeric Rating Scale,NRS)、造口相关并发症发生率、住院时间的差异。结果2组手术顺利,未发生严重并发症。观察组造口手术时间(19.5±3.8)min,显著短于对照组(25.7±5.8)min(t=-4.898,P=0.000);造口手术出血量(14.2±4.4)ml,明显少于对照组(18.7±5.6)ml(t=-3.461,P=0.001);术后24 h造口处疼痛NRS(2.2±1.0)分,明显低于对照组(3.2±1.0)分(t=-3.873,P=0.000)。2组造口相关并发症发生率分别为6.7%(2/30)、13.3%(4/30),差异无统计学意义(P=0.667);住院时间分别为(9.6±1.1)d、(9.7±1.0)d,差异无统计学意义(t=-0.368,P=0.714)。结论12 mm trocar应用在腹腔镜低位直肠癌根治术后预防性回肠造口中安全、可靠,值得临床推广应用。Objective To observe the clinical efficacy of 12 mm trocar in the prophylactic ileostomy after laparoscopic radical resection for low rectal cancer.Methods Clinical data of 60 patients with low rectal cancer in our department from March 2014 to December 2021 were analyzed retrospectively.The 30 patients who underwent the prophylactic ileostomy with 12 mm trocar from January 2018 to December 2021 were admitted to the observation group,while the other 30 patients who underwent conventional ostomy from March 2014 to December 2017 were admitted to the control group.The indexes such as operation time of ostomy,intraoperative bleeding volume of ostomy,Numeric Rating Scale(NRS)of stoma pain 24 h after operation,the incidence of ileostomy-related complications,and hospitalization time were compared.Results The operations were successfully completed in both groups without serious complications.The operation time of ostomy was(19.5±3.8)min in the observation group and(25.7±5.8)min in the control group,which showed a significant difference(t=-4.898,P=0.000).The intraoperative bleeding volume of ostomy was(14.2±4.4)ml in the observation group and(18.7±5.6)ml in the control group,which showed a significant difference(t=-3.461,P=0.001).The NRS of stoma pain 24 h after operation was(2.2±1.0)points in the observation group and(3.2±1.0)points in the control group,which showed a significant difference(t=-3.873,P=0.000).There was no significant difference between the two groups in the incidence of ileostomy-related complications[6.7%(2/30)vs.13.3%(4/30),P=0.667],and the hospitalization time[(9.6±1.1)d vs.(9.7±1.0)d,t=-0.368,P=0.714].Conclusions The 12 mm trocar is safe and reliable in the application of prophylactic ileostomy after laparoscopic radical resection for low rectal cancer.It is worthy of popularization and application in clinical parctice.

关 键 词：低位直肠癌 预防性回肠造口 

分 类 号：R735.37[医药卫生—肿瘤]