腹腔镜袢式回肠造口还纳术的临床效果分析:一项单中心回顾性研究  

Clinical effectiveness analysis of laparoscopic loop ileostom closure:a single-center retrospective study

作　　者：梁国刚 周云鹏[1] 王龙辉 陈玉[1] 冯立宗 王顺正 孙国志[1] Liang Guogang;Zhou Yunpeng;Wang Longhui;Chen Yu;Feng Lizong;Wang Shunzheng;Sun Guozhi(Department of General Surgery,Qingdao Eighth People’s Hospital Affiliated to Shandong Second Medical University,Qingdao 266100,Shandong,China)

机构地区：[1]山东第二医科大学附属青岛市第八人民医院普外科,山东青岛266100

出　　处：《结直肠肛门外科》2024年第5期557-561,共5页Journal of Colorectal & Anal Surgery

基　　金：山东第二医科大学附属医院(青岛市第八人民医院)科研发展基金资助项目(2023FYM083)

摘　　要：目的比较腹腔镜下袢式回肠造口还纳术与传统开腹袢式回肠造口还纳术的安全性及可行性。方法回顾性分析2020年6月至2024年6月山东第二医科大学附属青岛市第八人民医院收治的因结直肠手术行预防性袢式回肠造口的57例患者的临床资料,根据手术方式的不同,分为腹腔镜组(行腹腔镜下袢式回肠造口还纳术,n=27)和开腹组(行传统开腹袢式回肠造口还纳术,n=30)。比较两组术中情况(手术时间、术中出血量、手术切口长度)及术后情况(术后首次排气时间、术后疼痛程度、术后住院时间、术后并发症情况)。结果两组患者均顺利完成手术,腹腔镜组无中转开腹情况,无非计划性二次手术情况,无围手术期死亡病例。与开腹组相比,腹腔镜组手术时间更长,术中出血量更少,切口长度更短,差异有统计学意义(P<0.05)。与开腹组相比,腹腔镜组术后首次排气时间及住院时间更短、数字等级量表疼痛评分更低,差异有统计学意义(P<0.05)。术后腹腔镜组共有4例患者出现并发症,其中切口红肿渗出3例,肠梗阻1例;开腹组共有12例患者出现并发症,其中切口红肿渗出7例,切口出血1例,肠梗阻3例,吻合口狭窄不全梗阻1例,两组并发症发生率比较差异有统计学意义(P<0.05)。结论腹腔镜下袢式回肠造口还纳术是一种安全、微创、可行的手术方式,在减少术后并发症发生和加速术后康复方面表现良好。Objectives To compare the safety and feasibility of laparoscopic ileostomy reversal versus traditional open ileostomy reversal.Methods A retrospective analysis was conducted on the clinical data of 57 patients who underwent prophylactic loop ileostomy due to colorectal surgery at Qingdao Eighth People’s Hospital Affiliated to Shandong Second Medical University from June 2020 to June 2024.According to the different surgical methods,they were divided into the laparoscopic group(treated with laparoscopic ileostomy reversal surgery,n=27)and the open group(treated with traditional open ileostomy reversal surgery,n=30).The intraoperative(operative time,intraoperative blood loss,surgical incision length)and postoperative conditions(first postoperative exhaust time,postoperative pain level,postoperative hospitalization time,and postoperative complications)of the two groups were compared.Results There were no cases of conversion to open surgery in the laparoscopic group.Both groups of patients completed the surgery without any unplanned secondary surgery or perioperative deaths.Compared with the open surgery group,the laparoscopic group had a longer operative time,less intraoperative bleeding,and a shorter incision length,with statistically significant differences(P<0.05).The laparoscopic group also had a shorter first postoperative exhaust time and hospitalization time,as well as a lower numerical rating scale(NRS)pain score,compared with the open surgery group,with statistically significant differences(P<0.05).Four patients in the laparoscopic group experienced complications after surgery,including three cases of incision redness,swelling,and exudation,and one case of intestinal obstruction.In the open surgery group,there were 12 patients with complications,including seven instances of incision redness,swelling,and exudation,one case of incision bleeding,three cases of intestinal obstruction,and one case of anastomotic stenosis with incomplete obstruction.The difference in the incidence of complications between the tw

关 键 词：回肠造口 袢式回肠造口还纳术 腹腔镜 剖腹手术 

分 类 号：R574.6[医药卫生—消化系统]