中国全科医学2018，Vol.21Issue(12)：1481-1484,4.DOI:10.3969/j.issn.1007-9572.2018.00.102
管状吻合器及乙状结肠腹膜外造口在低位直肠癌经腹会阴联合切除术中的应用疗效分析
Extraperitoneal Sigmoid Colostomy Using Circular Stapler in Laparoscopic-assisted Abdominoperineal Resection of Low Rectal Cancer
摘要
Abstract
Objective To investigate the clinical effect of extraperitoneal sigmoid colostomy using circular stapler in laparoscopic-assisted abdominoperineal resection(APR) of low rectal cancer.Methods In this retrospective study, we enrolled 79 cases undergoing APR of low rectal cancer from The Affiliated Hospital of Southwest Medical University from January 2013 to September 2017.According to the way that the sigmoid colon was pulled through the abdominal incision and the anastomosis method,they were divided into extraperitoneal sigmoid colostomy using circular stapler(in laparoscopic-assisted APR of low rectal cancer) group(n=36),intraperitoneal sigmoid colostomy using circular stapler(in laparoscopic-assisted APR of low rectal cancer) group(n=22),extraperitoneal sigmoid colostomy using the traditional method(in open APR of low rectal cancer) group(n=9),and intraperitoneal sigmoid colostomy using the traditional method(in open APR of low rectal cancer) group(n=12).The outcome of colostomy,incidence of complications and patient satisfaction with the colostomywere compared between the groups.Results The regular defecation time and defecation times of the extraperitoneal sigmoid colostomy using circular stapler group were less than those of the intraperitoneal sigmoid colostomy using circular stapler group and the intraperitoneal sigmoid colostomy using the traditional method group(P<0.05).Compared with the extraperitoneal sigmoid colostomy using circular stapler group,extraperitoneal sigmoid colostomy using the traditional method group presented higher incidence of parastomal infection(P<0.05),intraperitoneal sigmoid colostomy using circular stapler group showed higher incidence of paraenterostomy hernia(P<0.05).All the groups exhibited similar incidence of parastomal hernia,stoma prolapsed/ retraction andsatisfaction(P>0.05).Conclusion Using extraperitoneal sigmoid colostomy with circular stapler is safe and suitable for patients undergoing laparoscopic-assisted APR of low rectal cancer,which can reduce the incidence of postoperative stoma complications and enhance the quality of life.关键词
直肠肿瘤/外科吻合口/肠造口术/手术后并发症Key words
Rectal neoplasms/Surgical stomas/Enterostomy/Postoperative complications分类
医药卫生引用本文复制引用
任磊,刘春凤,徐林霞,周业江..管状吻合器及乙状结肠腹膜外造口在低位直肠癌经腹会阴联合切除术中的应用疗效分析[J].中国全科医学,2018,21(12):1481-1484,4.基金项目
国家自然科学基金资助项目(30672058) （30672058）
西南医科大学附属医院科研课题(15118) （15118）
