Application of Specimen Extraction and Ileostomy Through Same Incision in Laparoscopic Anterior Resection of Rectal Cancer
10.3969/j.issn.1009-6604.2024.11.004
- VernacularTitle:同一切口取标本及回肠造口在腹腔镜直肠癌前切除术中的应用
- Author:
Haifeng ZHANG
1
;
Feng DONG
;
Zhaocheng GONG
Author Information
1. 浙江定海医院 上海瑞金医院舟山分院普通外科,舟山 316000
- Publication Type:Journal Article
- Keywords:
Low-to-mid rectal cancer;
Ileostomy
- From:
Chinese Journal of Minimally Invasive Surgery
2024;24(11):737-742
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss the safety and feasibility of extending the main operating port in the right lower abdomen for specimen collection while performing preventive ileostomy during laparoscopic anterior resection of rectal cancer.Methods A retrospective analysis of clinical data of 130 cases of laparoscopic anterior resection of rectal cancer combined with preventive ileostomy performed by the same surgeon from April 2021 to April 2024 was carried out.For patients with good mobility of the sigmoid colon and no significant edema of the mesentery,the main operating port in the right lower abdomen was extended to obtain specimens and perform ileostomy ( observation group,n=56 ).For those with insufficient mobility,short colon,and mesenteric edema,specimens were obtained through an auxiliary incision around the left of the umbilicus,and ileostomy was performed at the main operating port in the right lower abdomen (control group,n=74).The intraoperative indicators,postoperative indicators,and stoma-related complications of the two groups were compared.Results Both groups successfully completed the surgery.Compared to the control group,the observation group had a shorter surgery time[(133.6±7.1) min vs.(136.2±7.3) min,t=-1.972,P=0.005],lower pain scores at 24 h and 48 h postoperatively[(2.6±1.1) points vs.(2.9±1.3) points,t=-1.711,P=0.017;(1.5±0.6) points vs.(1.6±0.6) points,t=-1.437,P=0.042],and a shorter hospital stay postoperatively[(6.9±1.2) d vs.(7.2±1.3) d,t=-1.411,P=0.045].There were no significant differences in intraoperative blood loss,time to colostomy gas passage,time to start a liquid diet,and incidence of complications between the two groups (P>0.05).Conclusion For laparoscopic anterior resection combined with preventive ileostomy for low-to-mid rectal cancer,extending the main operating port in the right lower abdomen to obtain specimens and performing ileostomy is safe and feasible when there are good mobilization of the sigmoid colon and no significant edema of the mesentery,aligning with the principles of enhanced recovery after surgery.
