目的探讨应用回肠蕈状双腔造口预防腹腔镜直肠癌全直肠系膜切除(TME)术后吻合口漏的可行性。方法回顾性分析2006年4月至2010年3月辽宁省肿瘤医院大肠外科应用回肠蕈状双腔造口术预防腹腔镜TME术后吻合口漏的65例(造口组)及同期未行预防性造口的腹腔镜直肠癌TME手术85例(未造口组)病人临床资料。腹腔镜下完成低位或超低位吻合后,造口组于距回盲瓣30～40cm处回肠于右髂前上棘与脐连线外1/3处行双腔造口,回肠沿与纵轴垂直方向切开达1/2周,近端做蕈状乳头高于皮肤0.5cm,远端回肠平坦式缝合于皮肤。骶前放置双腔引流管。术后3～5个月闭瘘。未造口组仅骶前放置双腔引流管。结果造口组病人粪便转流彻底。无造口周围皮肤严重腐蚀与不耐受,无死亡病例,无吻合口漏。未造口组5例出现吻合口漏,3例4～8周后愈合,2例行手术造口治疗后治愈,无死亡病例。结论应用回肠蕈状双腔造口术预防腹腔镜直肠癌TME术后吻合口漏是可行的,造口护理方便,闭瘘创伤小,粪便转流彻底。 Objective To explore the feasibility of applying ileal mushroom double-cavity ostomy to prevent anastomotic leakage after laparoscopic total mesorectal excision (TME). Methods A retrospective analysis of 65 cases (stoma group) of laparoscopic anastomotic leakage after laparoscopic TME operation in colorectal surgery of Liaoning Provincial Tumor Hospital from April 2006 to March 2010 was performed retrospectively. Clinical data of 85 patients with stoma  laparoscopic TME surgery (without ostomy group). Laparoscopic complete low or ultra-low anastomosis, the stoma from the ileocecal valve at the ileum 30 ~ 40cm in the right anterior superior iliac spine and umbilical cane line outside the 1/3 double-cavity stoma, ileum along with the longitudinal axis Vertical cut open up to 1/2 weeks, the proximal mushroom head nipple 0.5cm higher than the skin, the distal ileum flat stitching the skin. Pre-sacral placement of double-lumen drainage tube. Postoperative 3 to 5 months closed fistula. No ostomy group placed before the sacral double-chamber drainage tube. The results of stool in patients with stool flow thoroughly. No severe skin corrosion and intolerance around the stoma, no deaths, no anastomotic leakage. In the non-stoma group, 5 cases showed anastomotic leakage, 3 cases healed after 4-8 weeks, and 2 cases were cured after operation stoma. No deaths were found. Conclusions The application of ileum mushroom double-cavity ostomy in preventing postoperative laparoscopic anastomotic leakage of TME is feasible. It is convenient for stoma care and traumatic fistula injury and thorough fecal flow.