【摘要】 目的探讨盆底腹膜重建与预防性末端回肠造口在腹腔镜直肠癌低位前切除术中的临床价值。方法回顾性分析2015年6月1日至2018年6月1日在该院胃肠外科住院的183例低位直肠癌患者的临床资料,其中既不行末端回肠造口也不重建盆底腹膜者71例(A组),盆底腹膜重建者61例(B组),预防性末端回肠造口者51例(C组),对比分析各组患者一般情况、肿瘤特征、住院费用及时间、并发症发生率等。结果 B、C组手术时间均长于A组,差异有统计学意义(P<0.05)。3组吻合口瘘的发生率比较,差异均无统计学意义(P>0.05)。A组术后再次手术率高于B、C组,差异均有统计学意义(P<0.05)。C组住院时间及总住院费用均高于A、B组,差异有统计学意义(P<0.05)。C组造口未还纳率为19.6%。结论盆底腹膜重建和预防性末端回肠造口在腹腔镜直肠癌低位前切除术中能降低因吻合口瘘造成的再次手术率,但预防性末端回肠造口增加了住院负担及造口相关并发症发生率。更多还原

【Abstract】 Objective To explore the clinical value of pelvic peritoneal reconstruction and preventive end ileostomy in laparoscopic low anterior resection of rectal cancer.Methods A retrospective analysis was made of the clinical data of 183 patients with low rectal cancer hospitalized in gastrointestinal surgery from June 1,2015 to June 1,2018.Among them,there were 71 cases without end ileostomy or pelvic peritoneum reconstruction(group A),61 cases of pelvic floor peritoneal reconstruction(group B)and 51 cases of prophylactic end ileostomy(group C).The general condition,tumor characteristics,hospitalization expenses,time and complication rate of each group were compared and analyzed.Results The operation time of the group B and C were longer than that of the group A,and the differences were significant(P<0.05).There were no significant differences in the incidence of anastomotic leakage among the three groups(P>0.05).The rate of reoperation in the group A were higher than that in the group B and C,and the differences were significant(P<0.05).The hospitalization time and total hospitalization expenses in the group C were higher than those in the group A and B,and the differences were statistically significant(P<0.05).The non-return rate of stoma in the group C was 19.6%.Conclusion Pelvic floor peritoneal reconstruction and prophylactic end ileostomy can reduce the rate of reoperation due to anastomotic leakage in laparoscopic low anterior resection of rectal cancer,but prophylactic end ileostomy increases the burden of hospitalization and the incidence of stoma-related complications.更多还原