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One-stitch versus traditional method of protective loop ileostomy in laparoscopic low anterior rectal resection: A retrospective comparative study

    作者

    Chen, YZ; Pei, WT; Wang, Q; Wang, WC; Xu, T; Jing, CQ; Li, LP; Zhang, JZ

    作者单位

    [Chen, Yuezhi; Wang, Wenchen; Xu, Tao; Jing, Changqing; Li, Leping; Zhang, Jizhun] Shandong First Med Univ, Dept Gastrointestinal Surg, Shandong Prov Hosp, Jinan 250021, Shandong, Peoples R China; [Chen, Yuezhi; Wang, Wenchen; Xu, Tao; Jing, Changqing; Li, Leping; Zhang, Jizhun] Shandong Univ, Dept Gastrointestinal Surg, Shandong Prov Hosp, Jinan 250021, Shandong, Peoples R China; [Pei, Wenting] Shandong Univ, Qilu Childrens Hosp, Jinan 250000, Shandong, Peoples R China; [Wang, Qiang] Shandong First Med Univ, Dept Personnel Off, Shandong Prov Hosp, Jinan 250021, Shandong, Peoples R China; [Wang, Qiang] Shandong Univ, Dept Personnel Off, Shandong Prov Hosp, Jinan 250021, Shandong, Peoples R China

    摘要

    Background: Protective loop ileostomy is widely performed during rectal resection surgery. The study aimed to introduce the one-stitch method (OM) of protective loop ileostomy in laparoscopic low anterior resection and compare this new method with the traditional method (TM). Materials and methods: A retrospective analysis was conducted on 109 patients with pathologically diagnosed adenocarcinoma of the rectum from January 2017 to December 2018 in the study centre, and the intraoperative details and postoperative outcomes of the two groups were measured. Results: A total of 95 patients were included: 54 underwent protective loop ileostomy with the TM, while 41 underwent surgery utilizing the OM. Univariate analysis demonstrated that the operative times of resection and closure were significantly shorter (resection, 200.0 vs. 227.5 min, P = 0.028; closure, 70.0 vs. 92.5 min, P = 0.018) and the peristomal adhesions during closure were milder (P = 0.007) in the OM group than in the TM group. The postoperative complications were similar in both groups. In multivariate analysis, the OM (OR 0.352, 95% CI = 0.155-0.799, P = 0.013) was a significant factor influencing the operative time of resection. The peristomal adhesion extent was the only independent risk factor for the stoma closure time (mild, OR 0.036, 95% CI = 0.010-0.129, P < 0.001; moderate, OR 0.128, 95% CI = 0.033-0.494, P = 0.003). No significant predictive factor of peristomal adhesion extent was identified in multivariable analysis. Conclusion: The OM of protective loop ileostomy in laparoscopic low anterior resection was time-saving, simple and easy to popularize and did not lead to more postoperative complications than the TM.

    关键词

    DIVERTING ILEOSTOMY; DEFUNCTIONING STOMA; PREVIOUS SURGERY; CANCER; CLOSURE
基本信息

  • 所属机构:胃肠

    归属医师: 王强 徐涛 张继准 陈悦之 靖昌庆 李乐平

    PMID:32650118

    UT:000561153700034

    刊名:INTERNATIONAL JOURNAL OF SURGERY

    年,卷(期):2020年80卷

    页码:117-123

    DOI:10.1016/j.ijsu.2020.06.035

    附件: other

    收录:   SCIE