Comparative Study Of Preventive Terminal Ileostomy And Colostomy For Anus Preservation In Low Rectal Cancer

Objective To compare the clinical laboratory indicators,surgical efficacy and complications in patients undergoing temporary preventive terminal ileostomy or colostomy for low rectal cancer.Method A total of 99 patients with low rectal cancer undergoing surgery from April 2015 to September 2019 in the First Hospital of Chongqing Medical University were analyzed statistically.Forty-nine cases underwent terminal ileostomy and 50 cases underwent colostomy.Independent sample t-test,Chi-square test and other statistical methods were used to analyze.Between the two groups,infection indexes,biochemical characteristics,complications,duration of surgery(min),time to exhaust/defecation(day)and length of hospital stay(day)were compared.Results Colostomy group the colon anastomotic fistula in 1 case(2.00%),ileal colostomy group 0 examples(0.00%),as a result there is no statistical difference(P > 0.05),in addition,colostomy group of the colon and ileal colostomy in the two groups occurred anastomotic stenosis rate(8.00% vs.2.04%),made fistula obstruction(6.00% vs.2.04%),made the stoma prolapse/retraction(10.00% vs.4.08%)and built around the fistula infection(8.00% vs.6.12%),The analysis showed no difference(P>0.05).The wound infection(after fistula closure)(16.00%vs.4.08%)was higher in the colon group and lower in the ileum,with significant difference(P<0.05).Electrolyte disturbance(Na,K)after treatment(32.00%vs.14.29%)was significantly higher than that in terminal ileostomy group,there were disparate in the above results(P<0.05)..In terms of laboratory indicators,the infection index(WBC,N%)and electrolyte disturbance(Na,K)of the colostomy group were significantly higher than those of the terminal ileostomy group on the first day after treatment(10.10,85.70 vs.7.80,77.40).The length of hospital stay(day),duration of operation(min)and time of exhaust and defecation(day)in the colon group were higher,the above findings suggest that there are differences between them(P<0.05).Conclusion Low rectal cancer preventive colostomy intraoperative,we use colon fistula with colostomy in preventing anastomotic fistula in the terminal ileum effect basic no difference,but the terminal ileum colostomy in shortening fistula operation time and close fistula of postoperative hospital stay,reduce electrolyte disorders and complications of colon fistula surgery,postoperative rehabilitation can be faster and better promote patients.