摘要
近年来,结直肠癌的治疗形成了以辅助放化疗、手术治疗、靶向及免疫治疗等多学科的综合治疗,但外科手术仍是最重要的治疗方式。部分低位直肠癌患者行低位直肠前切除术后,为了预防吻合口瘘的发生,可行预防性肠造口,一般常选择回肠末端、横结肠、乙状结肠作为预防性肠造口的位置,以回肠末端效果最佳。造口方式多种多样,目前国内以袢式回肠造口为主。为了降低吻合口瘘发生率,预防性回肠造口术已经被广泛应用,对于吻合口较低的直肠癌患者,采用预防性回肠袢式造口可降低吻合口瘘的发生率,回肠袢式造口术可解除肠道梗阻症状,加快患者术后恢复。回肠袢式造口术在长治医学院附属和平医院结直肠外科广泛应用,其临床应用价值已经临床实践证实,在结直肠癌中的应用有效性和安全性均较为理想,能够减轻对患者免疫功能产生的影响,有效减少并发症,促进患者预后改善。现研究针对回肠袢式造口方式进行分析,以期为临床合理选择术式提供指导和参考。
In recent years,the treatment of colorectal cancer has formed a multi-disciplinary comprehensive treatment with adjuvant radiotherapy and chemotherapy,surgical treatment,targeting and immunotherapy,but surgery is still the most important treatment.In order to prevent anastomotic fistula and prophylactic enterostomy after low anterior rectal resection for some patients with low rectal cancer,the end of ileum,transverse colon and sigmoid colon are usually selected as the locations for prophylactic enterostomy,and the end of ileum has the best effect.There are many kinds of ostomy methods,and loop ileostomy is the main one in China.Preventive ileostomy has been widely used to reduce the incidence of anastomotic fistula.For colorectal cancer patients with low anastomosis,prophylactic loop ileostomy can reduce the incidence of anastomotic fistula,relieve intestinal obstruction symptoms,and accelerate postoperative recovery.Loop ileostomy is widely used in the colorectal surgery department of Heping Hospital Affiliated to Changzhi Medical College,and its clinical application value has been proved by clinical practice.The efficacy and safety of the application in colorectal cancer are relatively ideal,which can reduce the impact on the immune function of patients,effectively reduce complications,and promote the improvement of patient prognosis.In this study,the method of loop ileostomy was analyzed in order to provide guidance and reference for clinical rational selection of operation.
作者
韩孝文
刘洪洲
吕彦东
Han Xiaowen;Liu Hongzhou;Lv Yandong(Graduate School of Changzhi Medical College,Changzhi 046000,Shanxi Province,China;Department of Colorectal Surgery,Heping Hospital Affiliated to Changzhi Medical University,Changzhi 046000,Shanxi Province,China)
出处
《中外医药研究》
2023年第17期160-162,共3页
JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH
关键词
结直肠癌
肠造口
回肠袢式造口
术后恢复
并发症
Colorectal cancer
Enterostomy
Loop ileostomy
Postoperative recovery
Complication
