微创根治术中预防性回肠末端造口对直肠癌患者临床疗效及肛门功能的影响

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Abstract Objective To investigate the effect of preventive ileostomy in minimally invasive radical operation on clinical efficacy and anal function in patients with rectal cancer. Methods A total of 91 patients with rectal cancer who were diagnosed and treated in the People’s Hospital of Chizhou, Anhui Province from September 2017 to May 2020 were selected as the research subjects, and they were divided into observation group and control group according to the operative methods. The observation group (32 cases) received laparoscopic radical resection combined with ileostomy, while the control group (59 cases) received laparoscopic radical resection alone. Perioperative indexes, changes in gastrointestinal function, postoperative recovery, laboratory indexes, anal function score and complications were compared between the two groups. Results There were no significant differences in intestinal sound recovery time, exhaust time, starting feeding time, operation time, intraoperative blood loss, length of resected lesions and total amount of lymph node dissection between the two groups (P ＞ 0.05). The time of getting out of bed for the first time, the number of days of fluid rehydration after operation and the length of hospital stay in the observation group were shorter than those in the control group, with statistical significance (P ＜ 0.05). The levels of white blood cells and C-reactive protein 2 and 5 d after operation were higher than those before operation, and the levels of pre-albumin were lower than those before operation. The levels of white blood cells and C-reactive protein 5 d after operation were lower than those 2 d after operation, and the levels of pre-albumin were higher than those 2 d after operation, with statistical significance (P ＜ 0.05). The levels of white blood cells in observation group were higher than those in control group at the same time point, and the levels of C-reactive protein and pre-albumin in observation group were lower than those in control group at the same time point. The levels of white blood cells and C-reactive protein at 5 d after operation were lower than those in the control group at the same time point, and the levels of pre-albumin were higher than those in the control group at the same time point, with statistical significance (all P ＜ 0.05). The scores of anal function at 14 d, 3 and 6 months after operation in both groups were higher than those before operation; those at 3 and 6 months after operation were higher than those at 14 d, and those at 6 months after operation were higher than those at three months after operation, with statistical significance (all P ＜ 0.05). The scores of anal function in the observation group at 14 d and 6 months after operation were higher than those in the control group at the same time point, and the scores at 3 months after operation were lower than those in the control group at the same time point, with statistical significance (P ＜ 0.05). There was no significant difference in the total incidence of complication between the two groups (P ＞ 0.05). Conclusion In patients with rectal cancer, the preventive of ileostomy during minimally invasive radical operation is beneficial to improve the anal function of patients and promote the improvement of life quality.

Key words： Laparoscopic Radical resection of colorectal cancer Preventive ileostomy Quality of life Anal function

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	SHI Jie HUA Shuqing CHEN Yun LI Xin WANG Wei

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SHI Jie HUA Shuqing CHEN Yun LI Xin WANG Wei. Effect of preventive ileostomy in minimally invasive radical operation on clinical efficacy and anal function in patients with rectal cancer[J]. 中国医药导报, 2021, 18(20): 91-95.

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https://www.yiyaodaobao.com.cn/EN/ OR https://www.yiyaodaobao.com.cn/EN/Y2021/V18/I20/91

[1] 牛晋卫，宁武，周雷，等.预防性皮瓣支撑末端回肠造口术在腹腔镜低位直肠癌根治术中的应用[J].中华医学杂志，2019，99（10）：750-753. DOI：10.3760/cma.j.issn.0376-2491.2019.10.008.
[2] 李伟，宋巍巍，张学峰，等.预防性回肠末端造口在腹腔镜直肠癌根治术中的应用价值[J].重庆医学，2019，48（11）：1882-1886. DOI：10.3969/j.issn.1671-8348.2019.11. 021.
[3] 谢凌铎，周鑫，谢海艇，等.腹腔镜直肠癌全直肠系膜切除术预防性末端回肠造瘘后相关并发症危险因素和造瘘还纳时机分析[J].中华胃肠外科杂志，2015，18（6）：563-567. DOI：10.3760/cma.j.issn.1671-0274.2015.06.012.
[4] 袁凯涛，马晋平.直肠癌低位前切除术行预防性回肠末端造口是否影响直肠肛门功能——一项随访长达12年的随机多中心研究[J].中华胃肠外科杂志，2017，20（9）：986. DOI：10.3760/j.issn.1671-0274.2017.09.008.
[5] 王强，王诗佳，陈敏，等.腹腔镜低位直肠癌行预防性回肠造口术中打开与否对吻合口漏的影响[J].南京医科大学学报：自然科学版，2018，38（9）：1307-1309，1313. DOI：10.7655/NYDXBNS20180927.
[6] 中华医学会外科学分会结直肠外科学组，中华医学会外科学分会腹腔镜与内镜外科学组.直肠癌经肛全直肠系膜切除中国专家共识及临床实践指南（2019版）[J].中国实用外科杂志，2019，39（11）：1121-1128. DOI：10. 19538/j.cjps.issn1005-2208.2019.11.01.
[7] 徐忠法.现代肛肠肿瘤外科学[M].济南：山东科学技术出版社，1993.
[8] 申旭波，刘方苇，熊世敏，等.基于WHOQOL-BREF量表的中老年男性生命质量现况分析[J].现代预防医学，2018， 45（6）：1118-1121.
[9] 杜涛，傅传刚.3D腹腔镜下直肠癌根治术中植物神经保护的研究[J].中华结直肠疾病电子杂志，2019，8（4）：31-34.
[10] Zakaria Z，Toomey D，Deasy J.Radiation-induced distal ileal obstruction complicating ileostomy closure [J]. Tech Coloproctol，2014，18（2）：195-198.
[11] Mengual-Ballester M, Pellicer-Franco E, Valero-Navarro G，et al. Population-based screening improves histop-athological prognostic factors in colorectal cancer [J]. Int J Colorectal Dis，2018，33（1）：23-28.
[12] 黄鲲，刘小双，赵权权，等.直肠癌根治术近端切缘距离的评估及临床意义[J].结直肠肛门外科，2019，25（2）：29-33.
[13] Shiwakoti E，Song J，Li J，et al. Prediction model for anastomotic leakage after laparoscopic rectal cancer resection [J]. J Int Med Res，2020，48（9）：300060520957547. DOI：10.1177/0300060520957547.
[14] 靖昌庆，陈悦之，田锋，等.降低直肠癌根治术后吻合口漏发生率对策[J].中国实用外科杂志，2020，40（3）：334-339.
[15] Crippa J，Duchalais E，Machairas N，et al. Long-term Oncological Outcomes Following Anastomotic Leak in Rectal Cancer Surgery [J]. Dis Colon Rectum，2020，63（6）：769-777. DOI：10.1097/DCR.0000000000001634.
[16] 王自强，杨廷翰.腹腔镜直肠癌根治术侧方淋巴结清扫术[J].中华普外科手术学杂志：电子版，2019，13（1）：16.
[17] Couwenberg AM，Intven MPW，Gregorowitsch ML，et al. Patient-Reported Work Ability During the First Two Years After Rectal Cancer Diagnosis [J]. Dis Colon Rectum，2020，63（5）：578-587. DOI：10.1097/DCR.0000000 000001601.
[18] 潘其华，吴帅，白鍊.保留左结肠动脉对腹腔镜直肠癌根治术手术安全性和疗效的影响[J].现代消化及介入诊疗，2019，24（6）：632-634.
[19] Bedrikovetski S，Dudi-Venkata NN，Kroon HM，et al. Outcomes of Minimally Invasive Versus Open Proctectomy for Rectal Cancer：A Propensity-Matched Analysis of Bi-National Colorectal Cancer Audit Data [J]. Dis Colon Rectum，2020，63（6）：778-787. DOI：10.1097/DCR.0000 000000001654.
[20] Ba M，Gaye P，Konate K，et al. Sexual and Urinary Disorders after Treatment of Rectal Cancer by Radiotherapy and Surgery at the Dantec University Hospital of Dakar [J]. Journal of Cancer Therapy，2020，11（5）：332-338. DOI：10.4236/jct.2020.115027.
[21] Ichihara M，Uemura M，Ikeda M，et al. Safety and Feasibility of Laparoscopic Pelvic Exenteration for Locally Advanced or Recurrent Colorectal Cancer [J]. Surg Laparosc Endosc Percutan Tech，2019，29（5）：389-392.
[22] Chen W，Liang JL，Ye JW，et al. Laparoscopy-assisted resection of colorectal cancer with situs inversus totalis：A case report and literature review [J]. World J Gastrointest Endosc，2020，12（9）：58-64.
[23] You X，Liu Q，Wu J，et al. High versus low ligation of inferior mesenteric artery during laparoscopic radical resection of rectal cancer：A retrospective cohort study [J]. Medicine（Baltimore），2020，99（12）：e19437.
[24] D?覿ster S，Xiang H，Yang J，et al. High prevalence of asymptomatic internal hernias after laparoscopic anterior resection in a retrospective analysis of postoperative computed tomography [J]. Int J Colorectal Dis，2020，35（5）：929-932.
[25] Kengo，Hayashi，Hiroki，et al. A Case of Multiple Colon Cancers Presented with Iliac Symptoms After Stoma Creation [J]. Nihon Fukubu Kyukyu Igakkai Zasshi （Journal of Abdominal Emergency Medicine），2019，39（1）：39-42.