腹膜外结肠造口在直肠癌Miles术中的应用价值

目的 探讨腹膜外结肠造口在直肠癌Miles术中临床应用价值.方法 直肠癌Miles术中,结肠造口分离造口段结肠时,从乙状结肠或降结肠系膜根部的后腹膜开始,手指从侧腹膜后间隙向造口方向钝性分离,先分离其后方,再分离前方,一直达腹壁造瘘外口,钝锐结合,切不能损伤腹膜,经腹膜外牵出乙状结肠或降结肠并外固定,腹膜内不需固定结肠.结果 术后患者恢复较快,大便成型表面出现早,排便规律提前,并发症少,生活质量高.结论 腹膜外结肠造口在直肠癌Miles术中操作方便,手术时间缩短,减少腹膜内固定结肠手术时间长、并发症多的缺点,患者术后恢复快,大便成型早,排便规律并发症少,值得临床推广.

Application of extroperitoneal laparocolostomy in Miles procedure of rectal carcinoma

Objective Outside the goal discussion peritoneum the colon makes the orifice in Rectal Cancer Miles technique the clinical practice value. Methods In the method Rectal Cancer Miles technique, colon makes when the mouth separation makes the mouth section colon, from the colon sigmoideum or falls the mescaline root after peritoneum to start, the finger to makes the mouth direction passivity separation from the side spatial retroperitoneale, separates first its rear area front, then separates, as soon as goes directly to the abdominal wall to make the fistula collar extension, the obtuse sharp union, cuts cannot damage the peritoneum, pulls the colon sigmoideum or the descending colon after the peritoneum outside and outside fixed, in the peritoneum does not need the fixed colon. Results finally the technique future trouble restores quickly, the bowel movement formation surface appears the morning, the bowel movement rule ahead of time, the complication are few, the quality of life is high. Conclusion Outside the conclusion peritoneum the colon makes the orifice in Rectal Cancer Miles technique the ease of operation, the surgery time reduces, reduces in the peritoneum the fixed colon surgery time to be long, Complication many shortcomings, after the patient technique restore quickly, the bowel movement formation, the bowel movement rule complication are early few, is worth the clinical promotion.