支架法转流术在低位直肠癌前切除术中的应用  

Application of stent bypass in anterior resection of low rectal cancer

作　　者：王雪 陈力 匡园园 徐文婷 王梦星 韦丁元 鲜雪梅 WANG Xue;CHEN Li;KUANG Yuan-yuan;XYU Wen-ting;WANG Meng-xing;WEI Ding-yuan;XIAN Xue-mei(Shihezi University School of Medicine,Xinjiang Shihezi,832002;Department of Colorectal Surgery,Sir Run Run Shaw Hospital,School of Medicine,Zhejiang University,Zhejiang Hangzhou,310020)

机构地区：[1]石河子大学医学院,新疆石河子832002 [2]浙江大学附属邵逸夫医院肛肠外科,浙江杭州310020

出　　处：《农垦医学》2024年第4期319-322,339,共5页Journal of Nongken Medicine

基　　金：浙江省医药卫生科技计划面上项目(2020KY586)。

摘　　要：目的:探讨支架法转流术在低位直肠癌前切除术中的应用。方法:回顾性分析2020年1月至2022年8月在浙江大学附属邵逸夫医院肛肠外科因低位直肠癌行直肠癌前切除术联合支架法转流术58例患者和行直肠癌前切除术联合回肠袢式造口术65例患者资料。比较两组患者围手术期相关指标及其术后并发症相关指标差异。结果:支架法转流术组和回肠袢式造口组患者基本资料比较差异均无统计学意义(P>0.05),住院总时间、治疗总费用、吻合口漏和肠梗阻发生率两组比较差异无统计学意义(P>0.05);支架法转流术手术时间、造口周围皮肤相关并发症发生率低于回肠袢式造口组(P<0.05);回肠袢式造口组进食时间、术后一个月BMI和营养不良发生率优于支架法转流术组(P<0.05)。结论:支架法转流术与回肠袢式造口相比可缩短手术时间,降低造口周围皮肤相关并发症发生率,可避免二期回纳手术,但术后营养不良发生率较高,需要进一步干预。Objective:To investigate the application of stent bypass in anterior resection of low rectal cancer.Methods:Data of 58 patients who underwent prerectal resection combined with stent bypass for low rectal cancer and 65 patients who underwent prerectal resection combined with loop ileostomy in the Department of Anorectal Surgery,Run Run Shaw Hospital Affiliated to Zhejiang University from January 2020 to August 2022 were retrospectively analyzed.The perioperative and postoperative complications were compared between the two groups.Results:There was no significant difference in basic data between the stent bypass group and the loop ileal stomy group(P>0.05),and there was no significant difference in total hospital stay,total treatment cost,incidence of anastomotic leakage and intestinal obstruction(P>0.05).The operative time of stent bypass and the incidence of peristomy skin related complications were better than those of loop ileal stomy group(P<0.05).The feeding time,BMI and malnutrition of one month after operation in loop ileal stomy group were better than those in stent bypass group(P<0.05).Conclusion:Compared with loop ileal ostomy,stent bypass can shorten the operation time,reduce the incidence of skin-related complications around the ostomy,and avoid the second-stage surgery.However,the incidence of postoperative malnutrition is higher,requiring further intervention.

关 键 词：直肠癌 支架 回肠造口术 

分 类 号：R656[医药卫生—外科学]