Eto Ken, Kosuge Makoto, Ohkuma Masahisa, Haruki Koichiro, Neki Kai, Mitsumori Norio, Ishida Katsuhiro, Yanaga Katsuhiko
Department of Surgery, Jikei University School of Medicine, Tokyo, Japan
Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
Anticancer Res. 2016 Aug;36(8):4139-44.
BACKGROUND/AIM: Laparoscopic surgery has made possible anterior resections with small incisions suitable for creating stomas. We retrospectively compared surgical results and stomal complications between transumbilical defunctioning ileostomy (TDI) and conventional defunctioning ileostomy (CDI) in laparoscopic anterior resections for rectal cancer.
We compared patients who underwent laparoscopic anterior resection with TDI (n=47) with those undergoing CDI (n=27) for rectal cancer between February 2011 and January 2015.
For the initial operations, the TDI group had significantly less intraoperative blood loss (30.3 ml vs. 117.0 ml; p=0.014). For stomal closure, the TDI group experienced significantly fewer wound infections (2 vs. 8 cases; p=0.002) and bowel obstructions (none vs. 3 cases; p=0.039). No significant differences in stomal complication rates were observed.
TDI is associated with better surgical results and fewer complications than CDI after laparoscopic anterior resection for rectal cancer.
背景/目的：腹腔镜手术使小切口前切除术成为可能，这种手术适合造口。我们回顾性比较了腹腔镜直肠癌前切除术中经脐转流性回肠造口术（TDI）与传统转流性回肠造口术（CDI）的手术结果及造口并发症。
我们比较了2011年2月至2015年1月间接受腹腔镜直肠癌前切除术并采用TDI（n = 47）的患者与采用CDI（n = 27）的患者。
在初次手术中，TDI组术中失血量显著更少（30.3毫升对117.0毫升；p = 0.014）。在造口关闭方面，TDI组伤口感染（2例对8例；p = 0.002）和肠梗阻（0例对3例；p = 0.039）显著更少。未观察到造口并发症发生率有显著差异。
在腹腔镜直肠癌前切除术后，TDI比CDI具有更好的手术结果且并发症更少。
