目的

观察“皮桥法”预防性回肠造口在低位直肠癌根治术中的效果，并分享相关治疗经验。

方法

前瞻性收集184例行腹腔镜低位直肠癌根治术并应用“皮桥法”行末端回肠预防性造口术的患者，对所有患者进行跟踪随访，统计临床相关资料，并观察术后并发症情况。针对该方法在围术期常见的造口相关问题进行分析讨论。

结果

184例患者行回肠造口术，中位用时5 min；其中118例患者行回肠造口还纳术，中位用时48 min，其中54例患者术后6个月行回肠造口还纳术，中位用时47 min；64例患者术后6个月以上行回肠造口还纳术，中位用时53.5 min。共27例（14.67%）患者出现造口相关并发症。15例（8.15%）患者发生造口皮肤黏膜分离；6例（3.26%）患者发生造口旁疝；10例（5.43%）患者出现造口周围潮湿相关皮炎；4例（2.17%）患者出现造口出血；2例（1.09%）患者出现造口狭窄。

结论

“皮桥法”预防性回肠造口手术操作时间短，造口相关并发症发生率较低，但应该注意操作细节。

Objective

To evaluate the effectiveness of the “Skin bridge loop ileostomy” technique in radical resection for low rectal cancer，and to share our clinical insights gained from this approach.

Methods

We prospectively collected 184 patients who underwent laparoscopic radical resection for low rectal cancer and received prophylactic ileostomy at the terminal ileum using the “skin - bridge loop ileostomy”. All patients were followed up，relevant clinical data were statistically analyzed，and postoperative complications were observed. The common stoma-related problems in the peri-operative period of this method were analyzed and discussed.

Results

Ileostomy was performed in 184 patients with a median duration of 5 min. Ileostomy reduction was performed in 118 patients with a median duration of 48 min，of which 54 patients underwent ileostomy reduction at 6 months postoperatively，with a median duration of 47 min.Sixty-four patients underwent ileostomy reduction at more than 6 months postoperatively，with a median duration of 53.5 min. A total of 27 patients （14.67%） experienced stoma-related complications. Among them，fifteen patients （8.15%） stoma skin-mucosal separation，six patients （3.26%） developed parastomal hernia，ten patients （5.43%） developed peristomal dermatitis，four patients （2.17%） developed stoma hemorrhage，and 2 patient （1.09%） developed stoma stenosis.

Conclusion

The “skin bridge loop ileostomy” technique in radical resection for low rectal cancer has a short operation time. The incidence of stoma - related complications is relatively low. However，attention should be paid to the details of this operation.