Application Analysis Of Preventive Loop Ileostomy In Laparoscopic Dixon Operation For Low Rectal Cancer

BackgroundColorectal cancer is a common malignant tumor of the digestive tract in my country,and its incidence is increasing year by year.The incidence of rectal cancer is higher than that of colon cancer.Currently,surgery is the most important means to treat rectal cancer.With the development and progress of medical technology,laparoscopic technology has been widely used in rectal cancer surgery.Relevant studies have shown that compared with traditional low rectal resection,laparoscopic surgery can achieve similar therapeutic effects.However,postoperative anastomotic leakage is still one of the common complications of laparoscopic surgery.Some studies have pointed out that preventive loop ileostomy can prevent the occurrence of postoperative anastomotic leakage.Therefore,preventive loop ileostomy is commonly used in Dixon surgery for rectal cancer.PurposeIntroduce the one-stitch method of preventive loop ileostomy in laparoscopic low rectal surgery,and compare this method with traditional method.MethodsThe study retrospectively analyzed the clinical data of 109 patients with rectal adenocarcinoma who were pathologically diagnosed in our medical center from January 2017 to December 2018.Patients who meet the inclusion criteria are divided into the traditional method of preventive loop ileostomy group(TM)and the one-stitch method of preventive loop ileostomy group(OM)according to different fistula methods,collect the basic data of the two groups of patients before the operation,the details of the operation and the relevant data of the postoperative outcome,and analyze the differences between the two groups of patients.ResultsA total of 95 patients were included,54 underwent preventive 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%Cl=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.ConclusionThe one-stitch method of preventive loop ileostomy(OM)in laparoscopic low anterior resection was time-saving,simple and easy to popularize and did not lead to more postoperative complications than the TM.