直肠癌手术中保护性结肠造口术与回肠造口术的比较

[Comparison of protective colostomy vs. ileostomy in rectal cancer surgery].

作者信息

Segura-González José Manuel Carlos, Tiscareño-Lozano Iris Isamar, García-Galicia Arturo, Hernández-Muñoz Samantha Isabel, Vera-Sánchez María Guadalupe, Maza-Cruz Alejandra Nayelhi, Montiel-Jarquín Álvaro José, Jiménez-Luna Ingrid

机构信息

Instituto Mexicano del Seguro Social, Centro Médico Nacional "Gral de Div. Manuel Ávila Camacho", Hospital de Especialidades de Puebla, Servicio de Cirugía General. Puebla de Zaragoza, México.

Instituto Mexicano del Seguro Social, Centro Médico Nacional "Gral de Div. Manuel Ávila Camacho", Hospital de Especialidades de Puebla, Dirección de Educación e Investigación en Salud. Puebla de Zaragoza, México.

出版信息

Rev Med Inst Mex Seguro Soc. 2023 Mar 1;61(2):133-139.

DOI:

PMID:37200516

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10396053/

Abstract

BACKGROUND

Rectal cancer (RC) is the 3rd most frequent one in Mexico. Protective stoma in resection and anastomosis is controversial.

OBJECTIVE

To compare quality of life (QoL), functional capacity (FC) and complications in rectal cancer (RC) patients with low and ultralow anterior resection (LAR and ULAR) with loop transverse colostomy (LTC) versus protective ileostomy (IP).

MATERIAL AND METHODS

Comparative, observational study in patients with RC and LTC (Group 1) or IP (Group 2) from 2018-2021. FC pre and postoperative, complications, hospital readmission (HR) and assessment by other specialty (AS) were assessed; QoL was assessed with EQ-5D by telephone. Student-t test, Chi-squared test, Mann-Whitney-U test were used.

RESULTS

Group 1: 12 patients: mean preoperative FC: ECOG 0.83, Karnofsky 91.66%; postoperative: ECOG 1, Karnofsky 89.17%. Mean postoperative QoL: index value 0.76 and health status 82.5%; HR: 25%; AS: 42%. Group 2: 10 patients: mean preoperative FC: ECOG 0.80, Karnofsky 90%; postoperative: ECOG 1.5, Karnofsky 84%. Mean postoperative QoL: index value 0.68 and health status 74%; HR: 50%; AS: 80%. Complications: 100% of sample.

CONCLUSION

The differences in QoL, FC and complications between LTC and IP in RC patients operated with LAR/ULAR were not significant.

摘要

背景

直肠癌（RC）是墨西哥第三常见的癌症。在直肠切除吻合术中使用保护性造口存在争议。

目的

比较低位和超低位前切除术（LAR和ULAR）的直肠癌（RC）患者行袢式横结肠造口术（LTC）与保护性回肠造口术（IP）后的生活质量（QoL）、功能能力（FC）及并发症情况。

材料与方法

对2018年至2021年期间行LTC（第1组）或IP（第2组）的RC患者进行比较性观察研究。评估术前和术后的FC、并发症、再次入院率（HR）以及其他专科评估（AS）；通过电话使用EQ-5D评估QoL。采用学生t检验、卡方检验、曼-惠特尼U检验。

结果

第1组：12例患者：术前平均FC：ECOG 0.83，卡诺夫斯基评分91.66%；术后：ECOG 1，卡诺夫斯基评分89.17%。术后平均QoL：指数值0.76，健康状况82.5%；HR：25%；AS：42%。第2组：10例患者：术前平均FC：ECOG 0.80，卡诺夫斯基评分90%；术后：ECOG 1.5，卡诺夫斯基评分84%。术后平均QoL：指数值0.68，健康状况74%；HR：50%；AS：80%。并发症：样本的100%。