Department of Gastrointestinal Surgery, Affiliated Hospital of Chengde Medical University, Chengde, China.
Department of Orthopedic, Affiliated Hospital of Chengde Medical University, Chengde, China.
J Int Med Res. 2022 Apr;50(4):3000605221094526. doi: 10.1177/03000605221094526.
To investigate the clinical effects of prophylactic transverse colostomy on gastrointestinal function recovery and complications in patients undergoing completely laparoscopic transabdominal approach partial intersphincteric resection (CLAPISR) of low rectal cancer.
We retrospectively analyzed the data of 74 patients with low rectal cancer who were treated with prophylactic transverse colostomy (Group A, n = 34) or without prophylactic transverse colostomy (Group B, n = 40). Surgery-related indicators, nutritional status indicators, systemic stress response indicators, and complications were compared between the two groups.
On postoperative day 5, the C-reactive protein concentration and white blood cell count were not significantly different between the two groups; however, the serum concentrations of total protein and albumin were higher in Group A than in Group B. Within 26 months postoperatively, the total incidence rate of complications was not significantly different, but the incidence rate of anastomotic leakage was lower in Group A than in Group B.
Prophylactic transverse colostomy based on CLAPISR can lead to faster recovery of gastrointestinal function, better improvement of postoperative nutritional indicators, and a lower incidence of anastomotic leakage. These characteristics are conducive to the rapid recovery of patients, making this procedure worthy of clinical application.
探讨预防性横结肠造口术对完全腹腔镜经腹入路超低位直肠癌保肛术（CLAPISR）患者胃肠功能恢复及并发症的影响。
回顾性分析 74 例行预防性横结肠造口术（A 组，n=34）或未行预防性横结肠造口术（B 组，n=40）的低位直肠癌患者的临床资料。比较两组患者的手术相关指标、营养状况指标、全身应激反应指标及并发症发生情况。
术后第 5 天，两组患者的 C 反应蛋白浓度和白细胞计数差异均无统计学意义；但 A 组患者的血清总蛋白和白蛋白浓度均高于 B 组。术后 26 个月内，两组患者的总并发症发生率差异无统计学意义，但 A 组患者的吻合口漏发生率低于 B 组。
基于 CLAPISR 的预防性横结肠造口术可加快胃肠功能恢复，改善术后营养指标，降低吻合口漏发生率，有利于患者快速康复，值得临床推广应用。
