末端回肠双腔造口与横结肠双腔造口的对比研究_崔伟

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1、第20卷第10期中国普通外科杂志Vol．20No．102011年10月ChineseJournalofGeneralSurgeryOct．2011文章编号:1005－6947(2011)10－1098－03·临床研究·末端回肠双腔造口与横结肠双腔造口的对比研究崔伟，陈纲，左富义，孙亮，于波［北京军区总医院普通外科(全军普通外科中心)，北京100700］摘要:目的比较末端回肠双腔造口与横结肠双腔造口的优缺点。方法回顾性分析接受临时性粪便转流的直肠癌保肛手术患者的临床资料，86例患者分为末端回肠双腔造口组(54例)与横结肠双腔造口组(32例)，比较两组患者的一般资料和与造口及造口还

2、纳相关的并发症发生情况。结果两组间吻合口瘘的发生率无统计学差异(P＞0．05)，末端回肠双腔造口组造口相关并发症的发生率(10．9%)明显低于横结肠双腔造口组(37．5%)(P＜0．05);末端回肠双腔造口组造口还纳相关并发症的发生率(10．0%)明显低于横结肠双腔造口组(32．0%)(P＜0．05)。结论对于高危的直肠癌保肛手术患者，推荐使用末端回肠双腔造口术来转流粪便。［中国普通外科杂志，2011，20(10):1098－1100］关键词:直肠肿瘤/外科学;末端回肠双腔造口;横结肠双腔造口;对比研究中图分类号:R735．3文献标识码:ADouble-barreltermin

3、alileostomyversusdouble-barreltransversecolostomyfortemporaryfecaldiversionaftersphincter-preservingsurgeryforrectalcancerCUIWei，CHENGang，ZUOFuyi，SUNLiang，YUBo(GeneralSurgeryCenterofPLA，DepartmentofGeneralSurgery，theGeneralHospitalofBeijingCommandofPLA，Beijing100700，China)Abstract:ObjectiveT

4、ocomparetheadvantagesanddisadvantagesofdouble-barrelterminalileostomyanddouble-barreltransversecolostomyfortemporaryfecaldiversionafteranus-preservingsurgeryforrectalcancer．MethodsTheclinicaldataofpatientsundergoinganus-preservingsurgeryforrectalcanceratourhospitalwereretrospectivelyanalyzed

5、．Fortemporaryfecaldiversion，54casesunderwentdouble-barrelterminalileostomyand32casesunderwentdouble-barreltransversecolostomy．Thegeneralmedicaldataandcomplica-tionsrelatedtostomaandstomaclosureofthepatientsbetweenthetwogroupswerecompared．ResultsNosignificantdifferencewasnotedbetweenthetwogro

6、upsintermsofincidenceofanastomoticleakage(P＞0．05)．Theincidenceofstoma-relatedcomplicationsofthedouble-barrelterminalileostomygroup(10．9%)wassignificantlylowerthanthatofthedouble-barreltransversecolostomygroup(37．5%)(P＜0．05)．Theincidenceofcomplicationsrelatedtostomaclosureofthedouble-barrelte

7、rminalileostomygroup(10．0%)wassignificantlylowerthanthatofthedouble-barreltransversecolostomygroup(32．0%)(P＜0．05)．ConclusionsDouble-barrelterminalileostomyisrecommendedtodivertthefecalstreamforthosehigh-riskpatientsfollowinganus-preservingsurgeryfo