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Effect of Prophylactic Ileostomy Distal Mucosal Closure on Anastomotic Fistula After Laparoscopic Radical Resection of Rectal Cancer and Its Related Factors |
LIU Ruqian, SU Zhijian, LIN Zhou |
The Affiliated Hospital of Jiangnan University, Jiangsu Wuxi 214000, China |
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Abstract Objective: To investigate the effect of prophylactic ileostomy distal mucosal closure on the occurrence of anastomotic fistula after laparoscopic radical resection of rectal cancer and its related factors. Methods: A retrospective analysis of the clinical data of 75 patients with rectal cancer admitted to our hospital from May 2019 to May 2020 was conducted. According to their surgical methods, they were divided into groups A (39 cases) and group B (36 cases). Group A was in laparoscopic rectal cancer. After radical cancer surgery, preventive ileostomy distal mucosal closure was performed. And group B received conventional laparoscopic radical rectal cancer surgery. The length of hospital stay, gastrointestinal function recovery time, anastomotic leakage healing time and postoperative occurrence were compared between the two groups, as well as the incision infection, intestinal adhesions and anastomotic leakage. According to whether an anastomotic leakage occurred after the operation, patients were subgrouped into anastomotic leakage group (10 cases) and non-anastomotic leakage group (65 cases). According to the results of univariate analysis, meaningful indicators were included into Logistic regression. Result: ① The postoperative hospital stay, gastrointestinal function recovery time and anastomotic fistula healing time in group A were lower than those in group B, P<0.05; ② The incidence of postoperative incision infection (5.13%), intestinal adhesion (7.69%) and anastomotic fistula (5.13%) in group A were significantly lower than those in group B (19.44%, 25.00%, 22.22%),P<0.05;③ Logistic regression showed that distance from tumor to anal margin was an independent risk factor for anastomotic fistula, P<0.05. Conclusion: Prophylaxis of distal mucosal closure of ileostomy after laparoscopic radical resection of rectal cancer has significant clinical effect on patients with rectal cancer, which can effectively reduce the probability of anastomotic fistula. The distance between tumor and anal margin is an independent risk factor for anastomotic fistula, which requires more clinical attention and targeted nursing care for patients.
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[1] 田剑波,温艳,杨卓煜,等.全球结直肠癌筛查指南及共识质量评价[J].中华流行病学杂志,2021,42(2):248~257. [2] 贾凌威,王曼,陈礼升.腹腔镜下直肠癌前切除术治疗低位直肠癌对手术指标的影响及并发直肠阴道瘘相关因素分析[J].河北医学,2021,27(3):461~466. [3] 吴巍,马冰,张於,等.中老年结直肠癌永久性造口患者心理痛苦现状及影响因素分析[J].河北医科大学学报,2020,41(12):1460~1464. [4] 张翔、王延磊、戴勇.直肠癌低位前切除术后吻合口漏的预防和诊治[J].结直肠肛门外科,2020,26(5):32~37. [5] 陈浩,熊永强,黄河.腹腔镜直肠癌根治术后吻合口瘘的危险因素[J].武警医学,2019,30(4):322~324. [6] 熊洋,宋林杰,折占飞,等.同时性结直肠癌肝转移一期切除术后并发症相关因素分析[J].中国现代普通外科进展,2020,23(2):122~125. [7] 崔磊,张清,柳益书,等.血清C反应蛋白对直肠癌患者术后吻合口瘘的预测价值[J].中国现代医学杂志,2020,30(6):96~100. [8] 刘赢,石欣.直肠低位前切除术预防性造口临床应用的进展[J].东南大学学报(医学版),2020,39(3):358~361. [9] 邹劲林,牛斌,林志东,等.预防性回肠造瘘在低位直肠癌保肛手术中的临床价值[J].中国医师杂志,2019,21(10):1545~1547. [10] 马静,陈振勇,肖维民,等.腹腔镜下直肠癌术后吻合口瘘危险因素的Meta分析[J].腹部外科,2019,32(5):370~375. |
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