Waike lilun yu shijian (Jan 2023)

Application of simple support bracket combined with one stitch suture in terminal ileostomy of rectal cancer

  • HU Lei, XU Yalong, LIU Shaojun, HE Yiren, LIU Liu, ZHU Zhiqiang

DOI
https://doi.org/10.16139/j.1007-9610.2023.01.13
Journal volume & issue
Vol. 28, no. 01
pp. 77 – 82

Abstract

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Objective To investigate the feasibility and effect of simple support bracket combined with one stitch suture in terminal ileostomy of two stomas during anus-preserving radical resection in low rectal cancer patients. Methods Retrospectively analysis was performed for rectal cancer patients with high risk factors for postoperative anastomotic leakage, who admitted to the Department of General Surgery our hospital from December 2019 to May 2021. The patients underwent laparoscopic-assisted low rectal cancer radical resection and terminal ileostomy. There were two groups including 35 patients in the group of simple bracket combined with one stitch suture, and 35 patients in the group of conventional suture. Preoperative and postoperative clinical data were analyzed. Results General data of two groups were similar. No difference statistical significantly in the rate of postoperative stoma‐related complications between the two groups ((P>0.05). All patients were without any severe complications. All stomas were successfully closed. The time of first-stage ileostomy (13.77±2.02) min vs. (22.66±3.64) min (P<0.001), second-stage stoma closure time (88.14±28.03) min vs. (103.29±30.96) min (P=0.04), and postoperative total time in hospital (14.54±2.32) d vs. (17.34±4.57) d (P=0.002) were shorter in simple bracket combined with one stitch suture group; both total cost in the hospital of first-stage operation (42 057.98±4 938.69) yuan vs. (44 728.46±5 223.62) yuan (P=0.03), and second-stage stoma closure blood loss (17.94±9.83) mL vs. (25.86±8.24) mL (P=0.001) lower compared with that in conventional suture group. Conclusions Simple support bracket combined with one stitch suture ileostomy did not increase postoperative stoma-related complications compared with conventional suture. However, it decreased the time for both first-stage ileostomy and second-stage stoma closure, and total cost in hospital. Therefore, it could be used for prophylactic ileostomy in low rectal cancer.

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