可崩解支架联合薄膜套粪便隔绝术预防低位直肠癌术后吻合口漏的效果分析

陈琪; 张顺涛; 高雨辰; 赵国威; 廖娟; 周雄; 孟文君; 白鍊

doi:10.16016/j.2097-0927.202310035

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可崩解支架联合薄膜套粪便隔绝术预防低位直肠癌术后吻合口漏的效果分析

临床医学 | 更新时间：2026-01-09

- 可崩解支架联合薄膜套粪便隔绝术预防低位直肠癌术后吻合口漏的效果分析
- Rubber-coated stent as a fecal isolation device to prevent postoperative anastomotic leakage after low rectal cancer: a cross-sectional study for efficacy
- 陆军军医大学学报 2024年46卷第5期页码：467-476
- 作者机构：
  
  1.402160 重庆，重庆医科大学附属永川医院胃肠外科
  2.402160 重庆，重庆医科大学附属永川医院消化内科
  3.102300 北京，北京市门头沟区医院普通外科
  4.402160 重庆，重庆医科大学附属永川医院中心实验室
  5.610041 成都，四川大学华西医院肿瘤中心生物治疗科
- 作者简介：
  
  [ 白鍊，E-mail: 19828386708@163.com BAI Lian, E-mail: 19828386708@163.com
- 基金信息：
  
  重庆市卫生健康委员会医学研究项目(2023WSJK010);重庆医科大学研究生创新基金(YJSCX202214)
- DOI：10.16016/j.2097-0927.202310035
  中图分类号： R181.32;R730.56;R735.37
- 收稿：2023-10-10，
  
  修回：2023-12-14，
  
  纸质出版：2024-03-15
- 稿件说明：
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陈琪, 张顺涛, 高雨辰, 等. 可崩解支架联合薄膜套粪便隔绝术预防低位直肠癌术后吻合口漏的效果分析[J]. 陆军军医大学学报, 2024,46(5):467-476.

Qi CHEN, Shuntao ZHANG, Yuchen GAO, et al. Rubber-coated stent as a fecal isolation device to prevent postoperative anastomotic leakage after low rectal cancer: a cross-sectional study for efficacy[J]. Journal of Army Medical University, 2024, 46(5): 467-476.
陈琪, 张顺涛, 高雨辰, 等. 可崩解支架联合薄膜套粪便隔绝术预防低位直肠癌术后吻合口漏的效果分析[J]. 陆军军医大学学报, 2024,46(5):467-476. DOI： 10.16016/j.2097-0927.202310035.

Qi CHEN, Shuntao ZHANG, Yuchen GAO, et al. Rubber-coated stent as a fecal isolation device to prevent postoperative anastomotic leakage after low rectal cancer: a cross-sectional study for efficacy[J]. Journal of Army Medical University, 2024, 46(5): 467-476. DOI： 10.16016/j.2097-0927.202310035.

摘要

目的

探讨可崩解支架联合薄膜套粪便隔绝术在预防低位直肠癌术后吻合口漏的应用。

方法

回顾性分析2016年1月至2023年4月在重庆医科大学附属永川医院行腹腔镜下低位直肠癌根治术(Dixon术式)的72名患者，其中行预防性造口的35名患者为观察组，行可崩解支架联合薄膜套粪便隔绝术的37名患者为研究组。比较2组患者的一般资料、手术时间、住院时间、总体并发症、住院费用、吻合口漏等指标。

结果

2组患者的一般资料(年龄、性别、BMI、NRS-2002评分、ASA分级、肿瘤分期、肿瘤距肛缘的距离)和合并基础疾病(糖尿病、高血压、其他心血管疾病、慢性阻塞性肺疾病)的比较差异均无统计学意义(

＞0.05)。研究组的手术时间(238.0

314.1 min

＜0.001)、术后住院时间(11

12 d，

=0.040)、总体并发症(18.9%

51.4%，

=0.004)及住院费用(48 327

53 092元，

=0.012)显著低于观察组。研究组吻合口漏率略低于观察组，但差异无统计学意义(2.7%

8.6%

=0.350)。

结论

可崩解支架联合薄膜套粪便隔绝术缩短手术时间和住院时间，降低住院费用和减少总体并发症，且吻合口漏的风险不高于传统手术，可作为预防性造口的替代手术方式。

Abstract

Objective

To investigate the application of rubber-coated stent (RCS) as a fecal isolation device in preventing anastomotic leakage after low rectal cancer surgery.

Methods

A total of 72 patients who underwent laparoscopic radical resection of rectal cancer (Dixon) at Yongchuan Hospital of Chongqing Medical University from January 2016 to April 2023 were studied

and 35 of them who underwent defunctioning stoma (DS) were assigned into control group

and another 37 ones receiving RCS served as the study group. Their general data

operation time

length of hospital stay

incidence of overall complications

hospitalization cost

anastomotic leakage rate

and other related clinical indicators were collected and compared between the 2 groups.

Results

There were no statistical differences between the 2 groups in term of general data (age

gender

BMI

NRS-2002 score

ASA score

tumor stage and distance from the tumor to the anal verge) and proportions of underlying diseases (diabetes mellitus

hypertension

other cardiovascular diseases

and chronic obstructive pulmonary disease) (

0.05). The study group had significantly shorter operation time (238.0

314.1 min

0.001) and length of postoperative hospital stay (11

12 d

=0.040)

lower incidence of overall complications (18.9%

51.4%

=0.004)

and less hospital cost (48 327

53 092 Yuan

=0.012) when compared with the control group. The rate of anastomotic leakage was slightly lower in the study group than the control group

though without statistical significance (2.7%

8.6%

=0.350).

Conclusion

In Dixon surgery

RCS shortens the operation time and length of hospital stay

reduces hospital cost and overall complications

and does not increase the risk of postoperative anastomotic leakage in comparison of conventional surgery. It can be used as a surgical alternative to DS.

关键词

Keywords

references

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