脐下正中切口预防性回肠造口在腹腔镜直肠癌根治术中的应用  

The application of preventive ileostomy through themidline incision under the umbilicus in laparoscopicradical resection of rectal cancer

作　　者：韩曲 金岩柏[1] 曾慧[1] HAN Qu;JIN Yanbai;ZENG Hui(Department of Gastrointestinal Surgery,Fengcheng People's Hospital,Yichun,Jiangxi,331100,China)

机构地区：[1]丰城市人民医院胃肠外科,江西宜春331100

出　　处：《当代医学》2024年第22期124-127,共4页Contemporary Medicine

摘　　要：目的探讨脐下正中切口预防性回肠造口在腹腔镜直肠癌根治术中的应用。方法选取2015年1月至2022年10月于丰城市人民医院行腹腔镜直肠癌根治术与预防性回肠造口治疗的76例直肠癌患者作为研究对象,按照随机数字表法分为观察组与对照组,每组38例。观察组行脐下正中切口,对照组行传统切口。比较两组围手术期相关指标、胃肠功能恢复情况、术后疼痛情况、造口还纳手术时间间隔及并发症发生情况。结果观察组切口长度、手术操作时间及术后下床时间均短于对照组,术中总出血量小于对照组,差异有统计学意义(P<0.05)。观察组术后排气时间、术后进食时间均短于对照组,差异有统计学意义(P<0.05);两组术后腹胀发生率比较差异无统计学意义。术后第1、3天,观察组视觉模拟评分法(visual analogue scale,VAS)评分均低于对照组,造口还纳手术时间间隔短于对照组,差异有统计学意义(P<0.05)。两组术后并发症发生率比较差异无统计学意义。结论腹腔镜直肠癌根治术后行预防性回肠造口治疗,脐下正中切口比传统切口更有优势,能改善术中相关指标,减轻疼痛,促进患者早期恢复,值得临床推广应用。Objective To investigate the application of preventive ileostomy with median incision under umbilicus in laparoscopic radical resection of rectal cancer.Methods A total of 76 patients who underwent laparoscopic radical resection of rectal cancer and preventive ileostomy in Fengcheng People's Hospital from January 2015 to October 2022 were selected as the study subjects,and they were divided into the observation group and the control group by using random number table method,with 38 cases in each group.The observation group underwent midumbilical incision and the control group underwent traditional incision.The perioperative indexes,gastrointestinal function recovery,postoperative pain,time interval and complications were compared between the two groups.Results The operative length,operation time and postoperative getting out of bed time in the observation group were shorter than those in the control group,and the total amount of intraoperative blood loss was lower than that in the control group,the difference was statistically significant(P<0.05).Postoperative exhaust time and postoperative feeding time in the observation group were shorter than those in the control group,the differences were statistically significant(P<0.05);there was no significant difference in the incidence of postoperative abdominal distension between the two groups.At the 1st day and the 3rd day after surgery,the postoperative visual analogue scale(VAS)scores in the observation group was lower than that in the control group,and the time interval of incision reduction was shorter than that in the control group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups.Conclusion The median subumbilical incision for prophylactic ileostomy after laparoscopic radical resection of rectal cancer has more advantages than the traditional incision,which can improve the relevant indexes during the operation,reduce pain and promote the early recovery

关 键 词：脐下正中切口 传统切口 预防性回肠造口 腹腔镜 直肠癌根治术 

分 类 号：R73[医药卫生—肿瘤]