Application And Analysis Of Tube Ileostomy Combined With Intraoperative Colon Lavage In Left Hemi-colon And Rectal Cancer With Acute Intestinal Obstruction

Objective:To study and explore the safety and effectiveness of intraoperative colon lavage combined with tubular ileostomy in patients with left hemi-colon and rectal cancer and acute intestinal obstruction.Methods:Collection of 80 cases of left-sided colon and rectal cancer with acute intestinal obstruction admitted to the Trauma Emergency Center of the First Affiliated Hospital of Nanchang University from January 1,2014 to December 31,2020,who underwent radical resection of colorectal cancer during hospitalization The general basic information,intraoperative indicators and postoperative indicators of the patients;21of them underwent intraoperative colon lavage + primary colon anastomosis +tracheal intubation and ileostomy,59 patients underwent primary tumor resection.The treatment of proximal colostomy and distal closure.Use statistical software SPPS20.0 for statistical analysis,when p<0.05,the difference is considered to be statistically significant Results:A total of 21 patients in group A ranged from 27 to 76 years old.Males accounted for 76.2% and females accounted for 23.8%.The average BMI value was(17.98±0.99)KG/M^2,and the stenosis caused by the tumor was located in the upper rectum.47.6%.According to TNM staging,stage III accounted for 76.2%.There were 59 patients in the B-sex group,with age distribution ranging from 16 to 79 years;males accounted for 54.2%;average BMI value was(18.49±1.94)KG/M^2,and the stenosis caused by the tumor was located in the upper rectum,accounting for 40.7%.According to TNM staging,stage III accounted for 64.4%.There were no significant differences in age,male to female ratio,BMI,ASA score of tumor-induced stenosis,and TNM staging(p>0.05).However,the operation time of the two groups was(256.43±67.88)min VS(189.83±41.54)min,the drainage tube extubation time was(28.14±1.80)d VS(5.47±1.42)d,and the first hospitalization fee was(50710±12917)yuan VS(38709)±6247)yuan,total hospitalization time(16.81±7.62)d VS(29.03±6.74)d,total hospitalization cost(50710±12917)yuan VS(67305±10513)yuan,etc.There are significant differences,with statistical significance(p<0.01).Conclusion:Tubular ileostomy combined with intraoperative colon lavage is a safe and effective technique as a preventive fistula in patients with left hemi-colon and rectal cancer and obstruction.Compared with the traditional colostomy,it has the advantages of avoiding the risk of secondary stoma recall surgery,saving medical resources,and reducing patient medical expenses.