预防性回肠双腔造口与单腔造口对腹腔镜低位直肠癌切除术后患者的影响  

Effect of prophylactic ileal double-lumen and single-lumen stoma on the patients after laparoscopic low rectal cancer resection

作　　者：王伯军 吴小红[1] 蒋奕 WANG Bojun;WU Xiaohong;JIANG Yi(Department of General Surgery,Yixing Hospital Affiliated to Jiangsu University,Jiangsu Province,Yixing 214200,China;Department of General Surgery,Yixing Fourth People’s Hospital,Jiangsu Province,Yixing 214200,China)

机构地区：[1]江苏大学附属宜兴医院普外科,江苏宜兴214200 [2]江苏省宜兴市第四人民医院普外科,江苏宜兴214200

出　　处：《中国医药导报》2022年第31期108-111,共4页China Medical Herald

基　　金：江苏省基础研究计划(自然科学基金)面上项目(BK20191118)。

摘　　要：目的探讨预防性回肠双腔造口与单腔造口对腹腔镜低位直肠癌切除术后患者的影响。方法选取2016年1月至2021年11月江苏大学附属宜兴医院收治的86例低位直肠癌患者进行前瞻性研究,采用随机数字表法将其分为单腔造口组(43例,单腔造口术)和双腔造口组(43例,双腔造口术)。统计两组Ⅰ、Ⅱ期手术的围手术期情况、术后并发症与转流性结肠炎(DC)发生情况。结果随访过程中双腔造口组失访3例,最终纳入研究40例。两组Ⅰ期手术时长、Ⅰ期术中出血量、Ⅰ期术后排气时间、Ⅰ期住院时间、Ⅱ期手术距Ⅰ期手术的时间、Ⅱ期术中出血量、两期术后并发症总发生率、Ⅱ期术后6个月内DC发生情况比较,差异无统计学意义(P>0.05)。双腔造口组Ⅱ期手术时长短于单腔造口组,差异有统计学意义(P<0.05)。两组Ⅰ期术后3个月内不同程度DC发生情况比较,差异有统计学意义(P<0.05)。结论腹腔镜低位直肠癌切除术后进行预防性回肠双腔造口与单腔造口均具有可行性,安全性较高,但双腔造口可以更好地降低DC发生,缩短Ⅱ期手术时间。Objective To investigate the effects of prophylactic ileal double-lumen and single-lumen stoma on the patients after laparoscopic low rectal cancer resection.Methods A total of 86 patients with low rectal cancer in Yixing Hospital Affiliated to Jiangsu University were selected from January 2016 to November 2021 for this prospective study.They were divided into single-lumen stoma group(43 cases,single-lumen stoma)and double-lumen stoma group(43 cases,double-lumen stoma)by random number table method.The perioperative conditions,postoperative complications,and diversion colitis(DC)of stageⅠandⅡoperation in the two groups were analyzed.Results In the double-lumen stoma group,three cases were lost to follow-up,and 40 cases were finally included in the study.There were no significant differences between the two groups in duration of stageⅠoperation,intraoperative blood loss of stageⅠoperation,exhaust time of stageⅠoperation,hospital stay of stageⅠoperation,time between stageⅠoperation and stageⅡoperation,intraoperative blood loss of stageⅡoperation,total incidence of complications of both two stage operation,and DC occurrence within six months after stageⅡoperation(P>0.05).The operation time of stageⅡin double-lumen stoma group was longer than that in single-lumen stoma group,and the difference was statistically significant(P<0.05).There was a significant difference in different level DC occurrence between the two groups within three months after stageⅠoperation(P<0.05).Conclusion Prophylactic ileal double-lumen and single lumen stoma after laparoscopic low rectal cancer resection are both feasible and safe,but double-lumen can better reduce the incidence of DC and shorten the operation time of stageⅡoperation.

关 键 词：双腔造口 单腔造口 腹腔镜 直肠癌 转流性结肠炎 

分 类 号：R735.3[医药卫生—肿瘤]