Clinical effects of prophylactic transverse colostomy in patients undergoing completely laparoscopic transabdominal approach partial intersphincteric resection

Honghong Zheng, Zhehong Li, Rui-dan Su, Jianjun Li, Shuai Zheng, Ji Yang, Enhong Zhao
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Abstract

Objective To investigate the clinical effects of prophylactic transverse colostomy on gastrointestinal function recovery and complications in patients undergoing completely laparoscopic transabdominal approach partial intersphincteric resection (CLAPISR) of low rectal cancer. Methods We retrospectively analyzed the data of 74 patients with low rectal cancer who were treated with prophylactic transverse colostomy (Group A, n = 34) or without prophylactic transverse colostomy (Group B, n = 40). Surgery-related indicators, nutritional status indicators, systemic stress response indicators, and complications were compared between the two groups. Results On postoperative day 5, the C-reactive protein concentration and white blood cell count were not significantly different between the two groups; however, the serum concentrations of total protein and albumin were higher in Group A than in Group B. Within 26 months postoperatively, the total incidence rate of complications was not significantly different, but the incidence rate of anastomotic leakage was lower in Group A than in Group B. Conclusion Prophylactic transverse colostomy based on CLAPISR can lead to faster recovery of gastrointestinal function, better improvement of postoperative nutritional indicators, and a lower incidence of anastomotic leakage. These characteristics are conducive to the rapid recovery of patients, making this procedure worthy of clinical application.
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腹腔镜下经腹入路部分括约肌切除术预防性横结肠造口术的临床效果
目的探讨预防性横结肠造口术对低位直肠癌腹腔镜经腹部分括约肌切除术(CLAPISR)患者胃肠功能恢复及并发症的影响。方法回顾性分析74例低位直肠癌行预防性横结肠造口术(A组,n = 34)和不行预防性横结肠造口术(B组,n = 40)的资料。比较两组手术相关指标、营养状况指标、全身应激反应指标及并发症。结果术后第5天,两组患者c反应蛋白浓度、白细胞计数差异无统计学意义;但血清总蛋白、白蛋白浓度A组高于b组。术后26个月内,并发症总发生率A组差异无统计学意义,但吻合口漏发生率A组低于b组。结论基于CLAPISR的预防性横结肠造口可使胃肠道功能恢复更快,术后营养指标改善更好。吻合口瘘发生率较低。这些特点有利于患者的快速康复,值得临床应用。
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