关键词: 直肠癌, 保护性造口, 吻合口漏, 造口回纳

Abstract:

Spontaneously closed protective stoma：a preliminary report of exploratory study        XU Jia-he, ZHOU Xi-le, WANG Jin-hai, et al. Department of Colorectal Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003，China
Corresponding author: XU Jia-he, E-mail：xhlenxhelen@yahoo.cn
Abstract    Objective    To explore the possibility of creating a protective stoma that may close spontaneously. Methods From March 2009 to February 2012, 128 cases of terminal ileum tube stoma and distal stapling with single row of staples for patients with at risk anastomosis, mainly for protection of low anterior resection for rectal cancer were performed in Department of Colorectal Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine.  Results    The success rate of reopen of the stapled intestinal was 100 percent. The mean time for anus to restore defecation, the period of protection of the anastomosis, was 29.3（12-75）days. The success rate of spontaneous closure of the stoma after removal of the tube was also 100 percent. The mean time of spontaneous closure of the stoma after removal of the tube was 12.4(7~30) days. There was one case of postoperative complication related to the tubing site. Neither complication related to intestinal stapling nor anastomotic leakage was found. Conclusion    The optimal mode of the operation is a single row stapling at the terminal ileum with a proximally placed tube ileostomy. The mean protection duration is about 4 weeks. During the time most anastomotic leakages if exist would have healed.

Key words: rectal cancer, protective stoma, anastomotic leakage, stoma closure