预防性末端回肠造瘘对降低高风险直肠癌患者术后吻合口瘘发生率的临床研究

目的探讨预防性末端回肠造瘘对减少高风险直肠癌患者术后吻合口瘘发生率的临床研究。方法选取2015年1月~2017年12月间在我院经肠镜取病理确诊为直肠癌且行Dixon手术治疗的患者40例,随机分为实验组和对照组,实验组行全直肠系膜切除术,术中行预防性末端回肠造瘘,对照组仅行全直肠系膜切除术,不做造瘘。比较两组患者手术时间、排气时间、引流管放置时间、住院时间、住院费用和并发症的发生率。结果实验组中患者的手术时间明显长于对照组,实验组患者的术后首次排气时间、引流管放置时间、住院时间都明显短于对照组,实验组的住院费用也明显低于对照组,实验组中患者吻合口瘘发生率明显低于对照组,以上差异均具有统计学意义(P0.05)。结论预防性末端回肠造瘘可以使患者术后肠道功能快速恢复,改善营养不良,提高免疫力,有效地降低高风险直肠癌患者术后吻合口瘘发生率。

Clinical study on prophylactic distal ileostomy for reducing the incidence rate of postoperative anastomotic leakage in the patients with high-risk rectal cancer

Objective To investigate the clinical study of prophylactic distal ileostomy for reducing the incidence rate of postoperative anastomotic leakage in the patients with high-risk rectal cancer.Methods 40 patients with rectal cancer who were diagnosed by colonoscopy and were given Dixon surgery in our hospital from January 2015 to December 2017 were selected.They were randomly divided into experimental group and control group.The experimental group was given total mesorectal excision and prophylactic distal ileostomy during the surgery.In the control group,the patients were only given total mesorectal excision and no ostomy was performed.The operation time,time of passage of gas,drainage tube placement time,length of stay,hospitalization costs,and incidence rate of complications were compared between the two groups.Results Patients in the experimental group had significantly longer operation time than the control group.The first-time postoperative passage of gas,drainage tube placement time,and length of stay were significantly shorter in the experimental group than in the control group.The hospitalization cost in the experimental group was also significantly lower than that in the control group.The incidence rate of anastomotic leakage in the experimental group was significantly lower than that in the control group,and the above differences were statistically significant(P<0.05).Conclusion Prophylactic distal ileostomy can rapidly recovery postoperative intestinal function,improve malnutrition,improve immunity,and effectively reduce the incidence rate of postoperative anastomotic leakage in the patients with high-risk rectal cancer.