结肠内旁路技术在低位直肠癌保肛手术中的应用-肿瘤学(肿瘤外科)专业论文.docxVIP

浙江大学医学院硕士学位论文Clinical 浙江大学医学院硕士学位论文 Clinical application of intracolonic bypass procedure for protection of the low rectal anastomosi S College of Medicine Zhejiang University Oncological Surgery Postgraduate Wang Danyang Supervisor Teng Lisong Lin Jianjiang Abstract PurDose：To assess the feasibility and safety of the Valtracm-secured intracolonic bypass(VIB)in protecting the low rectal anastomosis，and to compare the efficacy and complications of rib with those of loop ileostomy (LI)． Methods：From January 2002 to April 2006，44 patients with rectal cancer who underwent low anterior resect ion received VIB．Another 39 patients in the same period who underwent low anterior resection received LI．The demographics，clinical features，complication and operative data of two groups were analyzed and compared． Results：The demographics and cl inical features of 2 groups were simi lar． There were 2 cases in Group VIB and 2 in Group LI presented anastomotic dehiscence without any clinical manifestation．Longer postoperative hospital stay(21．3--+5．8d)and higher cost incurred(25．0-+7．2thousand yuan) were observed in Group LI than those(12．5±6．3d．35．1±9．3thousand yuan) in Group VIB(尺O．05)．Earlier time of the first flatus and oral intake(77．2 ±4．6h，81．2-+5．6h)were observed in Group LI than those(97．2±8．6h，108．2 ±7．6h)in Group VIB(尺0．05)．The stoma related compl ications included dermatitis(12．8％)，StOma bleeding(2．6％)and intestinal obstruction after stoma closure(5．1％)．None of VlB”lated complication occurred except for 浙江大学医学院硕士学位论文 浙江大学医学院硕士学位论文 BAR discharging disturbance in 2 cases(4．5％)． Conclusions：The VIB procedure is an established safe，feasible technique in protecting the low colorectal anastomosis，which can avoid the serious consequences of leakage．Compared with LI，VIB can avoid the stoma related complication and readmission for closure，it is also with advantages in postoperative hospital stay and cost． Key words Low rectal cancer；Anastomotic leakage；Loop ileostomy Intracolonic