腹膜外造口在腹腔镜腹会阴联合直肠癌根治术中的应用

发布时间：2018-04-25 11:58

本文选题：直肠癌 + 腹腔镜　；参考：《青海大学》2017年硕士论文

【摘要】：目的:对比腹膜外隧道式造口和腹膜内经腹腔造口二者在一般手术并发症、术后恢复和造口相关并发症上是否存在差异,讨论腹膜外造口的应用价值。方法:记录2015年12月至2016年12月就诊于青海大学附属医院胃肠肿瘤外科及腹部腔镜外科行腹腔镜辅助腹会阴联合直肠癌根治术的患者,选入腹膜外隧道式造口组35例为研究组,腹膜内经腹腔造口组30例为对照组。收集两组的相关临床资料进行对比分析。结果:一般情况的差异在两组间无统计学意义(P0.05);术中情况:研究组和对照组在手术时间(220.09±27.04和212.47±20.45,P0.05)、造口时间(23.43±2.67min和22.17±3.02,P0.05)和手术出血量(183.71±85.89ml和172.33±76.77,P0.05)的差异均无统计学意义。术后恢复:研究组和对照组在术后排气时间(中位数2d和3d,P0.05)和术后住院天数(14.71±6.91d和17.33±4.40d,P0.05)上的差异无统计学意义,而在术后造口排便时间(中位数2d和3d,P0.05)和首次进食时间(中位数2d和3d,P0.05)上差异有统计学意义。一般并发症:研究组6例,对照组7例,差异无统计学意义(P0.05)。造口并发症:研究组和对照组分别为9例和15例,两组差异在两组间有统计学意义(P0.05)。造口水肿研究组和对照组分别出现7例和1例,造口水肿两组患者的发生情况的差异有统计学意义(P0.05)。结论:腹膜外隧道式乙状结肠造口相较腹膜内经腹腔造口有降低造口相关并发症优势。术后消化功能恢复方面,腹膜外隧道式乙状结肠造口术后排便时间和进食时间早于腹膜内经腹腔造口。但是腹膜外隧道式乙状结肠造口患者造口水肿发生率较腹膜内乙状结肠造口患者高。
[Abstract]:Objective: to compare the difference between extraperitoneal tunnel orifice and intraperitoneal orifice in general complications, postoperative recovery and postoperative complications, and to discuss the application value of extraperitoneal orifice. Methods: from December 2015 to December 2016, 35 patients with gastroenteric neoplasms and abdominal endoscopic surgery underwent laparoscopically assisted abdominal perineum combined rectal cancer resection, and 35 patients were selected as the study group. The 30 cases in the intraperitoneal orifice group were the control group. The clinical data of the two groups were collected and compared. Results: there was no significant difference in general conditions between the two groups (P 0.05), but there was no significant difference between the two groups in the operative time (220.09 卤27.04 and 212.47 卤20.45), the operative time (23.43 卤2.67min) and the operative bleeding volume (183.71 卤85.89ml and 172.33 卤76.77 P0.05). Postoperative recovery: there was no significant difference between the study group and the control group in the postoperative exhaust time (median 2 d and 3 d P0.05) and the postoperative hospitalization days (14.71 卤6.91 d and 17.33 卤4.40 d P0.05). There was a significant difference in postoperative fecal time (median 2 d and 3 d P 0 05) and first feeding time (median 2 d and 3 d P 0 05). General complications: 6 cases in the study group and 7 cases in the control group, the difference was not statistically significant (P 0.05). Complications of anastomosis: 9 cases in the study group and 15 cases in the control group, the difference between the two groups was statistically significant (P 0.05). There were 7 cases and 1 case of ostomy edema in the study group and the control group respectively. There was significant difference in the occurrence of ostomy edema between the two groups (P 0.05). Conclusion: Extraperitoneal tunnel sigmoidostomy is superior to intraperitoneal orifice in reducing the complications associated with colostomy. The time of defecation and feeding after extraperitoneal tunnel sigmoidostomy was earlier than that of intraperitoneal stomy. However, the incidence of edema in patients with extraperitoneal tunnel sigmoidostomy was higher than that in patients with intraperitoneal sigmoidostomy.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.37

【相似文献】