低位直肠癌前切除术后预防性回肠造口方式对转流性结肠炎发病及转归的影响

目的 比较行预防性回肠单腔或双腔造口术对低位直肠癌前切除术后转流性结肠炎发病及转归的影响.方法 回顾性分析2015年1月至2019年9月于空军军医大学唐都医院接受腹腔镜低位直肠癌前切除术+预防性回肠造口术的147例患者的病例资料.按入排标准从中选取68例,根据造口方式不同分为单腔组(31例)和双腔组(37例),收集两组...

Effects of prophylactic ileostomy on incidence rate and outcome of diversion colitis after low anterior rectal resection due to rectal cancer

Objective To compare the effects of single or double lumen prophylactic ileostomy on the incidence rate and outcome of diversion colitis after low anterior rectal resection due to rectal cancer.Methods From January 2015 to September 2019,147 patients with low rectal cancer underwent laparoscopic anterior resection and prophylactic ileostomy in Tangdu Hospital of Air Force Military Medical University.According to the inclusion criteria,sixty-eight cases were divided into two groups according to the different ways of stoma:single lumen group(31 cases)and double lumen group(37 cases).We collected the basic clinical data of the two groups and the short-term results of the LAR+PI and the operation of ileostomy reversal.The endoscopic changes(edema,bleeding or contact bleeding)and the related clinical symptoms(serous/mucus/blood secretion,abdominal pain,tenesmus,diarrhea)3~4 months later after the ostomy and 4~6 months later after the ileostomy reversal were collected.Results The preoperative data of the two groups were comparable,except that the operation time of double lumen group was shorter than that of single lumen group(50.00±7.55 min vs.63.22±6.26 min,t=7.768;P<0.01).There was no statistical significance in the operation time,ileostomy reversal time,intraoperative bleeding volume,intestinal function recovery time,hospitalization time and recent postoperative complications of the two groups;The incidence rate of diversion colitis in the double lumen group was significantly lower than that in the single lumen group(54.1%vs.80.6%,χ²=5.328;P<0.05).There was a significant difference in severity of diversion colitis between the two groups(16.2%vs.51.6%,χ²=9.656;P<0.05).The incidence rate of diarrhea in the single lumen group was higher than that in the double lumen group(29.0%vs.8.1%,χ²=5.082;P<0.05).Conclusions Both single lumen and double lumen ileostomy are safe and feasible.Double lumen ileostomy may have more advantages in preventing the occurrence and improving the outcome of diversion colitis.