[Retrospective analysis of short-term curative effect of total laparoscopic loop ileostomy reversal after radical resection of rectal cancer]

Zhonghua Zhong Liu Za Zhi. 2022 Dec 23;44(12):1385-1390. doi: 10.3760/cma.j.cn112152-20200710-00643.
[Article in Chinese]

Abstract

Objective: To investigate the safety, feasibility and short-term efficacy of total laparoscopic loop ileostomy reversal in patients after resection of rectal cancer. Methods: The clinical data of 20 patients who underwent total laparoscopic loop ileoscopic loop ileostomy after radical resection of rectal cancer at Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, or Beijing Chaoyang District Sanhuan Cancer Hospital from October 2019 to June 2020 were collected and retrospectively analyzed. Results: All patients had successfully underwent total laparoscopic ileostomy reversal without conversion to open surgery or discontinued operation. No perioperative related death cases were found. In the whole group, the median operation time was 97 (60-145) minutes and the median intraoperative blood loss was 20 (10-100) milliliters. The median Visual Analogue Scale (VAS) score was 1.9 (1-5) one day after the operation. Nobody needed to use additional analgesic drugs. The median time to grand activities was 25 (16-42) hours, the median time to flatus was 44 (19-51) hours, and the median hospitalization after operation was 6.9 (5-9) days. No patients underwent operation related complications such as operative incision infection, abdominal and pelvic infection, intestinal obstruction, anastomotic leakage, bleeding and so on. Conclusions: Total laparoscopic loop ileostomy reversal appears to be safe, feasible and with promising efficacy for selected patients.

目的: 探讨直肠癌根治术后行完全腹腔镜回肠造口还纳术的安全性、可行性及其近期疗效。 方法: 回顾性分析2019年10月至2020年6月于中国医学科学院肿瘤医院和北京市朝阳区三环肿瘤医院行完全腹腔镜回肠袢式造口还纳术的20例直肠癌根治术后患者的临床资料,评价患者并发症发生情况、术后恢复情况及近期疗效。 结果: 全组20例行完全腹腔镜回肠造口还纳术患者均顺利完成手术,无中转开腹或中止手术者,无围手术期相关死亡患者。全组患者完全腹腔镜回肠造口还纳手术时间为60~145 min,中位时间为97 min;术中出血量为10~100 ml,中位出血量为20 ml。术后1 d视觉疼痛评分(VAS)为1.0~5.0分,术后1 d中位VAS为1.9分。全组患者麻醉清醒后均无需使用附加止痛药物。术后下床活动时间为16~42 h,中位时间为25 h;术后排气时间为19~51 h,中位时间为44 h;术后住院时间为5.0~9.0 d,中位时间为6.9 d。全组患者无手术相关切口感染、腹盆腔感染、肠梗阻、吻合口漏、出血等相关并发症。 结论: 经筛选的合适的患者行完全腹腔镜回肠造口还纳术安全可行,近期疗效满意,完全腹腔镜回肠造口还纳术是一种值得推广的手术方式。.

Keywords: Rectal neoplasms; Return of ileostomy; Safety; Total laparoscopic.

Publication types

  • English Abstract

MeSH terms

  • Anastomosis, Surgical
  • Anastomotic Leak
  • Humans
  • Ileostomy
  • Laparoscopy*
  • Rectal Neoplasms* / surgery
  • Retrospective Studies