【摘要】 目的评价腹腔镜下乙状结肠腹膜外造口术的临床应用价值。方法回顾性分析81例直肠癌Mile手术(直肠、肛管经腹会阴联合切除术)和Hartmann手术(经腹直肠癌切除、近端造口、远端封闭手术)行乙状结肠腹膜外造口的临床资料,其中包括开腹腹膜外乙状结肠造口45例、腹腔镜下经腹膜外乙状结肠造口术36例,比较两组患者造口手术时间以及并发症发生率。结果开放式腹膜外乙状结肠造口组、腹腔镜下腹膜外乙状结肠造口组,造口手术时间分别为32分钟、38.5分钟,两组手术时间比较差异无统计学意义(P>0.05)。开放式腹膜外乙状结肠造口组术后发生造口出血、缺血、水肿、周围皮炎分别为2、3、5、4例,总计14例,发生率为31.1%。腹腔镜下腹膜外乙状结肠造口组造口出血、缺血、水肿、周围皮炎分别为2、2、4、4例,总计12例,发生率为33.3%。两组患者并发症发生率比较差异无统计学意义(P>0.05)。两组患者均未出现腹内疝、造口旁疝、造口回缩、造口狭窄、造口脱垂等并发症。结论只要采取恰当的手术方法,在腹腔镜下进行腹膜外乙状结肠造口术,和开放性腹膜外乙状结肠造口术同样能取得了较好的手术效果。更多还原

【Abstract】 Objective To explore the clinical application value of extraperitoneal sigmoidostomy.Methods A retrospective analysis of 81 rectal cancer cases with Miles operation and Hartmann’s operation followed by extraperitoneal sigmoidostomy was carried out,including 36 cases of laparoscopic extraperitoneal sigmoidostomy and 45 cases of open extraperitoneal sigmoidostomy.The operation time and complication incidence between two groups were compared.Results There was no significant difference in operation time between the open surgery group and laparoscopy group(32 min vs 38.5 min,P>0.05).In open surgery group,there were 14 casesof complications,including 2 cases with bleeding,3 cases with ischemia,5 cases with stoma edema and 4 cases with dermatitis,and the complication incidence was31.11%.While in the laparoscopy group,there were 12 cases of complications,including 2 cases withbleeding,2 cases with ischemia,4 cases with edema,4 cases with dermatitis,and the complications incidence was 33.33%.There was no significant difference in the rate of complications.Besides,there were no major complications such as intra-abdominal hernia,parastomal hernia,retraction,stenosis,andprolapse.Conclusion With appropriate procedure,laparoscopic extraperitonealsigmoidostomy can also achieve satisfied clinical effect as well as opensurgery.更多还原