Ye Weipeng, Zhu Zhipeng, Liu Gang, Chen Borong, Zeng Junjie, Gao Jin, Wang Shengjie, Cai Hejie, Xu Guoxing, Huang Zhengjie
Department of Clinical Medicine, Fujian Medical University, Fuzhou.
Department of Gastrointestinal Surgery, Xiamen Cancer Hospital, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian.
Medicine (Baltimore). 2019 Jun;98(23):e15939. doi: 10.1097/MD.0000000000015939.
To investigate therapeutic effect of cuff rectum drainage tube (CDT) in preventing the postoperative complications of total mesorectal excision (TME) and promoting the recovery of the patients.The clinical data of 84 cases of low rectal cancer performed TME from June 2015 to June 2017 in the First Affiliated Hospital of Xiamen University were analyzed retrospectively. All the cases were performed anus-retained operation without preventive colostomy. Patients were divided into 2 groups according to the material of the anorectal drainage tube placed in the colonic cavity. Group I (CDT group) was transanal cuff rectal drainage tube placement (Patent No. ZL 201320384337.8) (n = 48), and group II (conventional group) was transanal clinical conventional drainage tube placement (n = 36). Anastomotic fistula incidence, the time of anal exsufflation, postoperative first ambulation time, intestinal function recovery time, the incidence of interrelated complications of drainage tube and postoperative hospital stay between 2 groups were analyzed retrospectively.Both postoperative first ambulation and anal exhaust time in CDT group were shorter than those in the conventional group ([2.3 ± 0.4] d vs [3.0 ± 0.2] d, P < .05; [3.3 ± 0.3] d vs [3.9 ± 0.5] d, P < .05). Meanwhile, the postoperative hospital stay of CDT group was significantly decreased than that in the conventional group ([10.3 ± 1.6] d vs [11.8 ± 1.1] d, P < .05). Significant different occurrence of complications existed in anastomotic fistula (2.1% [1/48] vs 16.7% [6/36], P < .05), frequent defecation (8.3% [4/48] vs 27.8% [10/36], P < .05), defecating unfinished feeling (12.5% [6/48] vs 30.6% [11/36], P < .05), drainage tube complication (4.2% [2/48] vs 22.2% [8/36], P < .05).The cuff rectum drainage tube may reduce incidence of anastomotic fistula after TME, shorten postoperative first ambulation and anal exsufflation time, enable faster recovery with good toleration and decrease postoperative hospital stay.
探讨荷包直肠引流管（CDT）在预防全直肠系膜切除术（TME）术后并发症及促进患者康复方面的治疗效果。回顾性分析2015年6月至2017年6月在厦门大学附属第一医院行TME的84例低位直肠癌患者的临床资料。所有病例均行保肛手术，未行预防性结肠造口术。根据放置于结肠腔内的肛管引流管材质将患者分为2组。Ⅰ组（CDT组）行经肛门荷包直肠引流管置入术（专利号：ZL 201320384337.8）（n = 48），Ⅱ组（传统组）行经肛门临床常规引流管置入术（n = 36）。回顾性分析两组患者吻合口瘘发生率、肛门排气时间、术后首次下床活动时间、肠功能恢复时间、引流管相关并发症发生率及术后住院时间。CDT组术后首次下床活动时间和肛门排气时间均短于传统组（[2.3±0.4]天 vs [3.0±0.2]天，P <.05；[3.3±0.3]天 vs [3.9±0.5]天，P <.05）。同时，CDT组术后住院时间明显短于传统组（[10.3±1.6]天 vs [11.8±1.1]天，P <.05）。两组在吻合口瘘（2.1% [1/48] vs 16.7% [6/36]，P <.05）、排便频数（8.3% [4/48] vs 27.8% [10/36]，P <.05）、排便不尽感（12.5% [6/48] vs 30.6% [11/36]，P <.05）、引流管并发症（4.2% [2/48] vs 22.2% [8/36]，P <.05）的发生情况上存在显著差异。荷包直肠引流管可降低TME术后吻合口瘘的发生率，缩短术后首次下床活动时间和肛门排气时间，使患者恢复更快、耐受性良好，并缩短术后住院时间。
