目的 探讨腹膜半包埋式乙状结肠造口在Miles术中的应用效果.方法 回顾性分析32例Miles术中采用改进后的腹膜半包埋式乙状结肠造口术的临床资料.造口时将造口用乙状结肠置于预先剪开的壁层腹膜中间,两侧剪开的腹膜分别与乙状结肠两侧浆肌层缝合,对乙状结肠形成半包埋.结果 32例均获随访,时间3～27个月,26例(81.25％)术后2个月排便规律,余6例大便不成形或腹泻,但4～6个月好转.仅1例术后出现造口狭窄,经造口重建后治愈,无与造口有关的远期并发症.结论 经改进后的腹膜半包埋式结肠造口术可有效地避免腹内疝、造口旁疝、造口回缩等并发症,为永久性结肠造口合理的术式.%Objective To investigate the clinical effects of peritoneal half-embedding sigmoidostomy in Miles operation for patients with low rectal cancer. Methods Clinical data of 32 cases underwent improved peritoneal half-embedding sigmoidostomy were retrospectively analyzed. The peritoneal half-embedding sigmoidostomy was operated as follows. First, the sigmoid colon for anastomosis was placed in the parietal peritoneum cut open in advance. Then, both ends of this sigmoid colon were made seromuscular layer suture with the both incisions of the parietal peritoneum respectively. Thus, the sigmoid colon was formed half-embedding by the parietal peritoneum. Results 32 cases were all followed up for 3-27 months. 26(81.25% ) patients had defecation feeling gradually. Only 1 case suffered from the stenostomy and got recovered by stoma reconstruction. No relevant long-term complication was observed. Conclusion The improvement of the peritoneal half-embedding sigmoidostomy can effectively avoid the complications such as internal hernias, colostomy side hernia, colostomy retraction, and may be a reasonable operation method for the permanent colostomy.
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