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中华普通外科学文献简介:中华普通外科学文献简介,中华普通外科学文献简介[详细]

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主管:
中华人民共和国国家卫生健康委员会
主办:
中华医学会
承办:
中山大学附属第一医院
中山大学附属中山医院
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总编辑: 王深明
编辑部主任: 汪谦
刊 期: 双月刊
创刊时间: 2007年2月
国内刊号: 11-9148/R
国际刊号: 1674-0793
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首页 > 期刊列表 > 改良末端回肠悬吊在腹腔镜下低位直肠癌根治术中的应用
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标题: 改良末端回肠悬吊在腹腔镜下低位直肠癌根治术中的应用
摘要:

目的:探讨改良末端回肠悬吊在腹腔镜下低位直肠癌根治术中的临床应用价值。方法:选取2017年7月至2019年7月收治住院的低位直肠癌患者,随机分为A、B、C三组,各30例:A组行腹腔镜下直肠癌根治术(Dixon);B组行Dixon加预防性末端回肠造口术;C组行Dixon加改良末端回肠悬吊术。比较三组术前1天及术后第1、3、7天营养学指标,外周血电解质浓度,住院总费用,术后首次下床活动时间、肛门首次排气时间、住院时间以及并发症发生率。结果:患者接受不同手术方式对营养物质及电解质的吸收利用未产生显著改变。B组肛门首次排气时间明显缩短(F=0.004,P<0.05),二次手术率(100.00%)与A、C组的3.33%(1/30)相比显著升高(χ2=81.562,P<0.001)。A组术后发生切口感染、吻合口瘘各1例(6.67%),B组发生造口相关并发症2例(6.67%),C组发生吻合口瘘1例(3.33%),三组患者术后并发症发生率比较,差异无统计学意义(χ2=0.424,P=0.809)。结论:改良末端回肠悬吊术操作简单,不影响患者术后恢复,能有效降低造口还纳手术率,减轻患者因造口带来的心理压力和二次手术的经济负担。

英文摘要: Objective:To discuss the clinical application of improved terminal ileum suspension in laparoscopic radical resection for low-rectal cancer. Methods:From July 2017 to July 2019, ninety pantients with low rectal cancer who underwent laparoscopic operation in the First People’s Hospital were randomly divided into three groups: Group A (30 cases) received laparoscopic radical resection of recral cancer (Dixon); Group B (30 cases) received Dixon and preventive ileostomy; Group C (30 cases) received Dixon and improved terminal ileum suspension. Peripheral blood nutritional indicators and the levels of electrolytes of three groups were observed 1 d before operation and 1, 3 and 7 d after operation. The three groups were compared in terms of first getting out-of-bed time, first exhaust time, postoperative hospital stay, total cost for hospitalization and postoperative complications. Results:The absorption and utilization of nutrients and electrolytes were not significantly changed by different operation methods. First exhaust time was earlier in the group B (F=0.004, P<0.05). Compared with 3.33% (1/30) of group A and group C, there-operation rate increased obviously (100.00%) (χ2=81.562,P<0.001). There were 1 case of incision infection and 1 case of anastomotic leakage (6.67%) in group A, 2 cases of stoma related complications (6.67%) in group B and 1 case of anastomotic leakage (3.33%) in group C. No statistical differences were shown in first getting out-of-bed time, postoperative hospital stay, total cost for hospitalization, postoperative complications among the three groups. Conclusion:Improved terminal ileum suspension is simple to operate, and does not affect the postoperative recovery of patients, effectively reducing the rate of small intestinal stoma closure operation, relieving the psychological pressure caused by stoma and the economic stress of secondary surgery.
作者:

殷刚1,2;曹少祥1;罗良弢1;刘文明1;谭海洋1;严想元1

作者单位: 湖北省天门市第一人民医院普通外科2区1;武汉科技大学职业危害识别与控制湖北省重点实验室2
期刊: 中华普通外科学文献(电子版)
年.卷(期):页码 2020 .14(4):271-275
中图分类号:
文章编号:
引用格式: [1]殷刚1,2;曹少祥1;罗良弢1;刘文明1;谭海洋1;严想元1.改良末端回肠悬吊在腹腔镜下低位直肠癌根治术中的应用[J/CD].中华普通外科学文献(电子版),2020,14(4):271-275 .
关键词: 直肠肿瘤;回肠造口术;末端回肠悬吊术;腹腔镜
英文关键词: Rectal neoplasms;Ileostomy;Terminal ileum suspension;Laparoscopes

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