腹膜外结肠造口在腹腔镜直肠癌Miles术中的应用

目的探讨腹膜外结肠造口在腹腔镜直肠癌根治术中的应用效果。 方法回顾性分析经腹膜外造口的患者48例和经腹造口患者64例的临床资料，两组均行腹腔镜手术，比较2组术后近期及远期造口并发症发生情况。 结果术后围手术并发症、近期造口并发症发生率及术后首次排气、排便时间之间的差异均无统计学意义。两组术后住院天数的差异无统计学意义。腹膜外组比经腹腔组造口旁疝及造口脱垂发生率低，差异有统计学意义（P<0.05）。 结论腹腔镜技术下经腹膜外结肠造口较经腹腔造口近期并发症发生率相似，但远期造口相关并发症发生率低，患者生活质量较高，临床值得推广。

The application of extraperitoneal laparocolostomy in laparoscopic radical resection for rectal carcinoma

ObjectiveTo investigate the value of application of extraperitoneal laparocolostomy in laparoscopic radical resection of rectal carcinoma. MethodsIn this retrospective study, 112 rectal cancer patients under laparoscopic radical resection were enrolled, including 48 patients with extraperitoneal laparocolostomy and 64 patients with traditional laparocolostomy. Differences of clinical characters, early and long-term stomal complications after laparocolostomy between the two groups were analyzed. ResultsThere were no significant differences in the incidence of perioperative complications, early stomal complications, and the time of first passing flatus and defecation between the two groups. Still, the hospitalization time between the two groups was no statistical significance. However, patients in extraperitoneal group, compared with the other group, showed lower rates of incident of para-stoma hernia and stomal prolapse (P<0.05). ConclusionsAlthough patients with laparoscopic extraperitoneal laparocolostomy had a similar incidence of early stomal complications with patients under traditional laparocolostomy, they had a lower incident of long-term stomal complications and a better quality of life, which proved that laparoscopic extraperitoneal laparocolostomy is of high clinical value.