老年低位直肠癌全系膜切除预防性回肠造瘘应用

目的分析老年低位直肠癌全系膜切除术中预防性回肠造瘘的应用价值，评价其疗效，探讨其临床适用性。方法对2009年3月至2012年10月于我院行低位直肠癌全系膜切除术的90例老年患者的临床资料进行回顾性分析，简单随机分为实验组40例和对照组50例，对照组仅行低位直肠癌全系膜切除术，实验组在此基础上加预防性回肠造瘘。观察并比较两组患者吻合口漏的发生率。结果实验组加用预防性回肠造瘘吻合口漏发生率为2．5％。而对照组患者吻合V1漏发生率为16％，两组发生率比较，差异有统计学意义（x2=4．5，P〈0．05）。结论老年低位直肠癌全系膜切除术中预防性回肠造瘘在一定的适应症下有助于减少吻合口瘘的发生情况，对患者的恢复有很好的保护作用，适合临床长期推广应用。

Application of preventive ileostomy in total mesorectal excision for low rectal cancer in elderly patients

Objective To analyze of the application of preventive ileostomy in total mesorectal excision for low rectal cancer in elderly patients and to assess its efficacy. Methods The clinical data were retrospectively analyzed in 90 elderly patients with low rectal cancer who had undergone total mesorectal resection in our hospital during the period of March 2009 to October 2012. The patients were randomly divided into a study group （40 patients） and a control group （50 patients）. The control group received total mesangial resection alone, while the study group received preventive ileostomy in addition to total mesangial resection. The incidence rate of anastomotic leak was observed and compared between the two groups. Ptesults There was significant difference in the incidence rate of anastomotic leak between the study group and the control group （2.5% vs. 16%; X 2= 4.5, P〈0.05）. Conclusicm Preventive ileostomy in total mesorectal excision for low rectal cancer in elderly patients is helpful in reducing the occurrence of anastomotic leak and has a better role in patient recovery. It is worth popularizing clinically.