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中华结直肠疾病电子杂志 ›› 2021, Vol. 10 ›› Issue (04) : 357 -361. doi: 10.3877/cma.j.issn.2095-3224.2021.04.004

论著

完全腹腔镜与传统开放回肠袢式造口还纳术的疗效对比研究
罗寿1, 苏昊1, 徐正1, 梁建伟1, 刘骞1, 周志祥1, 王锡山1, 周海涛1,()   
  1. 1. 北京 100021,国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院结直肠外科
  • 收稿日期:2020-12-06 出版日期:2021-08-30
  • 通信作者: 周海涛
  • 基金资助:
    中国医学科学院医学与健康科技创新工程(协同创新团队项目)(2017-I2M-4-002); 北京协和医学院2018年度研究生创新基金项目(2018-1002-02-26); 2018年度北京市东城区优秀人才计划

Retrospective analysis of short-term curative effect of total laparoscopic and open loop ileostomy reversal

Shou Luo1, Hao Su1, Zheng Xu1, Jianwei Liang1, Qian Liu1, Zhixiang Zhou1, Xishan Wang1, Haitao Zhou1,()   

  1. 1. Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
  • Received:2020-12-06 Published:2021-08-30
  • Corresponding author: Haitao Zhou
引用本文:

罗寿, 苏昊, 徐正, 梁建伟, 刘骞, 周志祥, 王锡山, 周海涛. 完全腹腔镜与传统开放回肠袢式造口还纳术的疗效对比研究[J/OL]. 中华结直肠疾病电子杂志, 2021, 10(04): 357-361.

Shou Luo, Hao Su, Zheng Xu, Jianwei Liang, Qian Liu, Zhixiang Zhou, Xishan Wang, Haitao Zhou. Retrospective analysis of short-term curative effect of total laparoscopic and open loop ileostomy reversal[J/OL]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2021, 10(04): 357-361.

目的

对比完全腹腔镜与传统开放回肠袢式造口还纳术的近期疗效,探讨完全腹腔镜技术应用于回肠袢式造口还纳术的安全性及可行性。

方法

回顾性分析2018年1月至2020年8月在中国医学科学院肿瘤医院结直肠外科行回肠袢式造口还纳术的60例患者的临床资料,其中完全腹腔镜手术组27例,传统开放手术组33例,比较分析两组的手术安全性及近期疗效。

结果

入组患者均顺利完成手术,无中转开腹或围手术期死亡病例。两组患者在年龄、性别、体质指数、术前合并症及是否行辅助放化疗等基线临床资料方面比较差异无统计学意义。完全腹腔镜手术组切口长度明显短于传统开放手术组[(5.7±1.4)cm vs.(7.8±1.1)cm],差异有统计学意义(t=-6.622,P<0.001)。完全腹腔镜手术组在术后首次下地活动时间[1(1~1)d vs. 1(1~2)d]、术后首次排气时间[2(1~3)d vs. 2(2~3)d]、术后住院时间[6(5~7)d vs. 7(6~9)d]、术后并发症发生率[3.7%(1/27) vs. 24.2%(8/33)]等方面均优于传统开放手术组(P<0.05)。完全腹腔镜手术组手术时间长于传统开放手术组[(98.0±24.5)min vs.(89.4±17.5)min],但差异无统计学意义(P>0.05)。

结论

完全腹腔镜回肠袢式造口还纳术胃肠功能恢复快,术后住院时间缩短,手术并发症发生率降低,是安全可行的微创手术方式。

Objective

To compare the short-term outcome of total laparoscopic and open loop ileostomy reversal.

Methods

A retrospective review was performed for 60 consecutive patients who underwent loop ileostomy reversal between January 2018 to August 2020, at Department of Colorectal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. Twenty-seven patients were treated with total laparoscopic loop ileostomy while 33 patients were open cases. The baseline characteristics, operative outcomes, postoperative recovery and postoperative complications of these patients were identified and retrospectively analyzed.

Results

All patients had been successfully accomplished loop ileostomy reversal without discontinued operation. No perioperative related death cases were found in the whole group. There was no significant difference in the clinical characteristics between the two groups. The length of incision in the total laparoscopic surgery group was significantly shorter than that in the traditional open surgery group [(5.7±1.4) cm vs. (7.8±1.1) cm, t=-6.622], and the difference was statistically significant (P<0.001). There were significant differences between the two groups in the first ground activities [1 (1~1) d vs. 1(1~2) d], first flatus passage [2(1~3) d vs. 2(2~3) d], postoperative hospitalization days [6(5~7) d vs. 7(6~9) d], the postoperative complications [3.7% (1/27) vs. 24.2% (8/33)]. The total operative time of laparoscopic surgery group was longer than that of the traditional open surgery group [(98.0±24.5) min vs. (89.4±17.5) min], but the difference was not statistically significant. (P>0.05)

Conclusion

This retrospective study demonstrated that total laparoscopic loop ileostomy reversal might be a safe and feasible procedure, with a lower postoperative complications and a shorter postoperative hospitalization time.

表1 两组患者临床资料分析[例(%)]
表2 完全腹腔镜手术组与传统开放手术组安全性及近期疗效比较
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