改良袢式回肠末端造瘘在左半结肠癌根治术患者中的应用研究

摘要

Objective To investigate value of modified loop end ileostomy in treatment of primary left colon cancer.Methods Clinical data of 90 patients with left colon cancer who underwent radical resection and primary anastomosis in our hospital were analyzed retrospectively.There were 45 patients each in Modified loop ileostomy (treatment group) group and no modified loop ileostomy (control group) group.The operation time,blood loss,fasting time,anal exhaust time,drainage time and length of stay were compared between the two groups.The incidence of complications was recorded and the event-free survival rate was analyzed at 3 year after operation.Results Fasting time [(2.54±0.86) d],anal exhaust time [(2.98±1.06) d],drainage tube pull out time [(5.63±1.56) d],hospitalization time [(16.07±2.65) d] in the treatment group were shorter than those in the control group (P ＜ 0.05).The complication rate in the treatment group was lower than that in the control group (P ＜ 0.05).The cumulative event-free survival rate in the treatment group was significantly higher than that in the control group (P ＜ 0.05).Conclusion Modified loop ileostomy can promote postoperative recovery,shorten the length of stay and reduce postoperative complications,which especially reduce the incidence of anastomotic leakage and improve the long-term survival rate.%目的 探讨改良袢式回肠末端造瘘在左半结肠癌根治术患者中应用的临床效果.方法 回顾性分析本院90例行左半结肠癌根治术患者的临床资料,将术后加改良袢式回肠末端造瘘分为观察组,未加改良袢式回肠末端造瘘分为对照组,每组各45例.对比两组手术时间、术中出血量、禁食时间、肛门排气时间、引流管拔出时间、住院时间,记录并发症发生率,并分析术后3年无事件生存率.结果 观察组禁食时间(2.54±0.86)d、肛门排气时间(2.98±1.06)d、引流管拔出时间(5.63±1.56)d、住院时间(16.07±2.65)d均短于对照组(P＜0.05).观察组并发症发生率显著低于对照组(P＜0.05).观察组累积无事件生存率显著高于对照组(P＜0.05).结论 改良袢式回肠末端造瘘可促左半结肠癌患者进术后恢复,缩短住院时间,减少术后并发症,尤其可降低术后吻合口瘘发生率,有利于改善患者远期生存率.