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目的探讨回肠造口在直肠癌低位前切除中的作用。方法回顾性分析我院2008年6月至2010年9月48例直肠癌低位前切除术患者,其中行预防性回肠造口者和未造口者各24例。造口组组行低位癌切除术同时预防性回肠造口,非造口组组仅行直肠癌低位前切除术。比较两组患者围手术期死亡及并发症发生率。结果两组患者均顺利完成手术,无围手术期死亡病例。①造口组发生吻合口瘘1例(4.2%)显著低于非造口组4例(16.0%)(P<0.05)。②造口组发生肠梗阻2例(8.3%)非造口组发生肠梗阻2例(8.3%)无明显区别(P>0.05)。③造口组切口感染1例(4.2%)低于对照组3例(12.5%)(P<0.05)。④再次开腹手术率方面,治疗组0例(0%)显著低于对照组2例(8.3%)(P<0.05)。两组均未发生死亡病例。结论对于直肠癌低位前切除患者实行预防性回肠造口能明显降低术后吻合口瘘发生率,伤口感染率及再次开腹手率。
Objective To investigate the role of ileostomy in the anterior resection of low rectal cancer. Methods A retrospective analysis of our hospital from June 2008 to September 2010 48 cases of patients with low anterior resection of rectal cancer patients, including preventive ileostomy and non-stoma in 24 cases. Ostomy group low cancer resection line at the same time preventive ileostomy, non-stoma group only low anterior resection of colorectal cancer. Perioperative mortality and complication rates were compared between the two groups. Results The two groups of patients were successfully completed surgery, no perioperative deaths. ① One case (4.2%) of anastomotic leakage occurred in the stoma group was significantly lower than that in the non-stoma group (16.0%) (P <0.05). ② There were 2 cases (4.3%) of intestinal obstruction in the stoma group and 2 cases (8.3%) in the non-stoma group had no significant difference (P> 0.05). ③ Incision infection in 1 case (4.2%) was lower than that in control group (12.5%) (P <0.05). ④ In reoperation rate, there were 0 cases (0%) in treatment group and 2 cases (8.3%) in control group (P <0.05). No deaths occurred in either group. Conclusions The implementation of prophylactic ileostomy for patients with low anterior resection of rectal cancer can significantly reduce the incidence of postoperative anastomotic leakage, wound infection and reopening rate.