摘要
末端回肠造口是降低直肠癌术后吻合口漏(anastomotic leakage,AL)严重程度和减少术后严重并发症的重要术式。末端回肠造口决策与外科医生的主观判断及病人AL风险有关。目前缺乏客观的临床指南,末端回肠造口的决策主要依赖于外科医生的经验。大量研究开发或提出的诸如赋分模型、Nomogram模型、专家共识、临床指南、人工智能(artificial intelligence,AI)模型等致力于预测术后AL或合理决策末端回肠造口的实施,虽有部分研究展示出了良好的预期效果,但仍缺少高质量数据的验证。目前,合理决策末端回肠造口的实施仍在摸索中前行,我们相信随着术中吻合口检测新技术的发展及临床高质量大数据研究的推进,末端回肠造口的个体化实施可以在不久的将来得到实现。
The terminal ileostomy is an important surgical procedure for reducing the severity of anastomotic leakage(AL)and serious postoperative complications in rectal cancer surgery.The decision of terminal ileostomy is related to the subjective judgment of surgeons and the risk of AL,however,due to the lack of objective clinical guidelines,the decision of terminal ileostomy mainly relies on the surgeons’experience.A large number of researches have developed or proposed some tools,such as scoring models,Nomogram,expert consensus,clinical guidelines,and artificial intelligence(AI)models,are dedicated to predicting postoperative AL or making reasonable decisions for the implementation of terminal ileostomy.Although some studies have shown favorable expected results,there is still a lack of high-quality data validation.At present,the rational implementation of decision-making for terminal ileostomy is still being explored.It is believable that the personalized implementation of terminal ileostomy can be achieved in the near future with the development of new technologies for intraoperative anastomosis detection and the advancement of high-quality clinical big data research.
作者
邵胜利
覃吉超
SHAO Shengli;QIN Jichao(Department of Gastrointestinal Surgery,The First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou,310003,China)
出处
《临床外科杂志》
2024年第5期549-552,共4页
Journal of Clinical Surgery
关键词
直肠癌
末端回肠造口
吻合口漏
Rectal cancer
Terminal ileostomy
Anastomotic leakage
