Abstract:
Objective To explore the effects of modified one-needle terminal ileostomy on stress response and safety of patients undergoing anal preservation for low rectal cancer.
Methods The data of patients with rectal preservation for low rectal cancer admitted from January 2021 to January 2023 were retrospectively analyzed, and the patients were divided into observation group (modified one-needle terminal ileostomy, n=55 cases) and control group (traditional terminal ileostomy, n=43 cases) according to different stomy schemes. SPSS 22.0 software was used to analyze the data. Perioperative indexes, anal dynamics and stress response indexes at different times were expressed as (
). Independent sample t test was performed between groups. Analysis of variance between groups with multiple time point comparisons to repeat measures. The cases and percentage of postoperative complications were expressed by χ2 test. P<0.05 was statistically significant.
Results The operation time and postoperative recovery time in the observation group were significantly shorter than those in the control group (P<0.05). The anal dynamic indexes in the two groups showed a trend of first decreasing and then increasing at different time points (all P<0.05), and the anal dynamic indexes in the observation group were significantly higher than those in the control group 6 months after surgery (P<0.05). The stress response indexes (white blood cell count (WBC), C-reactive protein (CRP), tumor necrosis factor α (TNF-α)) in the two groups at different time points showed a trend of first increase and then decrease (all P<0.05), and postoperative 2d TNF-α in the observation group was significantly lower than that in the control group (P<0.05). The stress response indexes were significantly lower than those of control group at 5 days after operation (P<0.05). The total incidence of stomation-related complications in the observation group was significantly lower than that in the control group (3.6% VS. 20.9%, P<0.05).
Conclusion Modified one-needle terminal ileostomy has positive effects on stress response and safety after anal preservation for low rectal cancer. It can shorten operation time and promote patient recovery.
Key words:
Rectal Neoplasms,
Proctectomy,
Terminal Ileostomy,
Improved One-Stitch Technique,
Stress Response
Zijun Zhao, Yunsheng Lan. Effect of modified one-shot terminal ileostomy on stress response and safety after anal preservation for low rectal cancer[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(06): 611-614.