摘要
目的 探讨乙状结肠腹膜外造口一期乳头成形在Miles术中应用的临床效果。方法 将接受Miles手术的 186例病人分为两组 ,实验组 92例施行乙状结肠腹膜外造口一期乳头成形术 ,对照组 94例行传统的腹膜内结肠造口术 ,比较两组病人的造口并发症和排便功能改善情况。结果 实验组 92例病人中的 75例经过 3～60个月的随访 ,有 2例发生造口狭窄 ,并发症发生率为 2 7% ,62例病人获排便感 (占 82 7% )。对照组 94例中的 78例经过 3～ 60个月的随访 ,发生造口段肠缺血坏死 2例 ,肠脱垂 3例 ,腹内疝 2例 ,造口回缩 3例 ,造口处切口疝 2例 ,造口狭窄 6例 ,各种并发症的发生率为 2 3 1% ,2 1例病人有排便感 (占 2 6 9% ) ,两组比较差异均有显著性 (P <0 0 5 ) ,实验组与肠造口有关的并发症明显低于对照组 ,而其术后所获排便感明显高于后者。结论 乙状结肠腹膜外造口一期乳头成形术具有术后并发症发生率低和排便功能恢复好的优点 ,可提高病人术后的生活质量 。
Objective To explore the clinical effects of the extraperitoneal sigmoidostomy and its primary mammilliplasty in Miles operation. Methods One hundred and eighty-six patients with low rectal and anus carcinoma who received Miles operation were divided into two groups. The experimental group of 92 patients received extraperitoneal sigmoidostomy and its primary mammilliplasty, while the control group of 94 cases received the traditional intraperitoneal sigmoidostomy. Postoperative complications caused by sigmoidostomy and defecation function in these two groups were compared.Results Seventy-five patients who received extraperitoneal sigmoidostomy and its primary mammilliplasty were followed up for 3～60months. Only two of them suffered from sigmoidostomic stenosis. The morbidity of complications caused by sigmoidostomy was 2 7% and 62 patients(82 7%) got continence sigmoidostomies. Seventy eight patients who received the traditional intraperitoneal sigmoidostomy were also followed up for 3～60months. The morbidity of complications caused by sigmoidostomy in control group was much higher(23 1%) and only 21 cases(26 9%) got continence sigmoidostomies. The latter's complications included 2 cases of sigmoidostomic necrosis, 3 colon prolapse, 2 abdominal internal hernia, 3 sigmoidostomic retraction, 2 sigmoidostomic incisional hernia and 6 sigmoidostomic stenosis. There was significant difference in the two aspects between the two groups (P<0 05). Conclusion \ The extraperitoneal sigmoidostomy and its primary mammilliplasty has the advantages of less complications and better defecation functions. This operation should be used widely in clinical practice.
出处
《中国实用外科杂志》
CSCD
北大核心
2003年第6期353-354,共2页
Chinese Journal of Practical Surgery
