One-stitch versus traditional method of protective loop ileostomy in laparoscopic low anterior rectal resection: A retrospective comparative study
One-stitch versus traditional method of protective loop ileostomy in laparoscopic low anterior rectal resection: A retrospective comparative study
复制标题
一针与传统保护环回肠造口术在腹腔镜低位直肠前切除术中的回顾性比较研究
DOI：
10.1016/j.ijsu.2020.06.035
复制
发表时间：
2020-08-01
影响因子：
15.3
通讯作者：
Zhang, Jizhun
中科院分区：
文献类型：
--
作者：
Chen, Yuezhi;Pei, Wenting;Zhang, Jizhun
Background: Protective loop ileostomy is widely performed during rectal resection surgery. The study aimed to introduce the one-stitch method (OM) of protective loop ileostomy in laparoscopic low anterior resection and compare this new method with the traditional method (TM).Materials and methods: A retrospective analysis was conducted on 109 patients with pathologically diagnosed adenocarcinoma of the rectum from January 2017 to December 2018 in the study centre, and the intraoperative details and postoperative outcomes of the two groups were measured.Results: A total of 95 patients were included: 54 underwent protective 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% CI = 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.Conclusion: The OM of protective loop ileostomy in laparoscopic low anterior resection was time-saving, simple and easy to popularize and did not lead to more postoperative complications than the TM.
