Varghese Gigi, Shankar Bharat, Dsouza Royson, Jesudason Mark Ranjan
Department of Colorectal Surgery, Christian Medical College Hospital, Vellore, Tamil Nadu India.
Department of General Surgery, Christian Medical College Hospital, Vellore, Tamil Nadu India.
Indian J Surg Oncol. 2023 Jun;14(2):387-391. doi: 10.1007/s13193-020-01179-3. Epub 2020 Aug 10.
Diversion colostomy plays a crucial role in the management of carcinoma rectum in low- and middle-income countries as significant number of patients present with partial intestinal obstruction. The aim of this study was to compare laparoscopic and open approaches for fecal diversion done in patients with adenocarcinoma of the rectum as a pretreatment procedure. The primary end point of our study was time to initiation of neoadjuvant chemo radiation. It was a retrospective study that included all patients diagnosed to have carcinoma rectum and underwent a pretreatment fecal diversion between 2012 and 2014. A total of 55 patients underwent pretreatment diversion colostomy of which 33 were performed via the laparoscopic approach while 22 had open diversion. The time for initiation of neoadjuvant therapy was shorter in the laparoscopic group compared to the open approach (16 days vs. 20.5 days, = 0.31). The study concluded that pretreatment diversion colostomy using the laparoscopic approach was a safe option in low- and middle-income countries as it was associated with faster recovery and early initiation of neoadjuvant therapy in patients with partially obstructed locally advanced carcinoma rectum.
在中低收入国家，转流性结肠造口术在直肠癌的治疗中起着关键作用，因为有相当数量的患者存在部分肠梗阻。本研究的目的是比较腹腔镜和开放手术两种方式在直肠癌患者中作为预处理步骤进行粪便转流的效果。我们研究的主要终点是开始新辅助化疗放疗的时间。这是一项回顾性研究，纳入了2012年至2014年间所有被诊断为直肠癌并接受预处理粪便转流的患者。共有55例患者接受了预处理转流性结肠造口术，其中33例通过腹腔镜手术进行，22例采用开放手术。与开放手术相比，腹腔镜组开始新辅助治疗的时间更短（16天对20.5天，=0.31）。该研究得出结论，在中低收入国家，采用腹腔镜手术进行预处理转流性结肠造口术是一种安全的选择，因为它能使局部晚期直肠癌伴部分梗阻的患者恢复更快，并能更早开始新辅助治疗。
