目的 评估单层缝合技术用于预防性末端回肠造口术的有效性。方法 选取2016年1月—2023年6月期间接受腹腔镜下直肠前切除术并进行预防性末端回肠造口的142例患者进行回顾性分析。剔除2例未进行造口还纳的患者,并根据手术方法将患者分为观察组（单层缝合,70例）和对照组（传统缝合,70例）。观察指标包括：患者的一般临床特征、造口手术时间（不包括直肠癌手术时间）、造口相关并发症（如造口狭窄、皮炎、旁疝、分离、脱垂、回缩及坏死）、造口还纳时间、腹腔内粘连程度及造口还纳术后并发症（切口感染、切口疝、肠梗阻）等。结果 两组在基线数据上没有显著差异（P>0.05）。观察组的造口缝合时间、还纳操作时间、造口还纳时间均明显低于对照组,差异具有统计学意义（P<0.05）;观察组的腹腔内粘连程度显著低于对照组（P<0.05）;在造口相关并发症、造口还纳术后切口感染及肠梗阻发生率的比较中,两组间差异均无统计学意义（P>0.05）;观察组造口还纳术后切口疝发生率低于对照组,差异有统计学意义（P<0.05）。结论 相较于传统缝合方法,单层缝合技术在直肠癌前切除术中能够有效缩短造口缝合及还纳手术时间,并减轻腹腔内粘连的发生。
Objective To evaluate the effectiveness of single-layer suturing technique in preventive terminal ileostomy. Methods A retrospective analysis was conducted on 142 patients who underwent laparoscopic anterior resection and preventive terminal ileostomy from January 2016 to June 2023, excluding 2 patients who did not undergo stoma reversal. The patients were divided into an observation group （single-layer suturing, 70 cases） and a control group （traditional suturing, 70 cases） based on the surgical methods. The observation indicators encompassed patients' general clinical characteristics, the time of stoma surgery （excluding the time for rectal cancer surgery）, stoma-related complications （e.g. stoma stenosis, dermatitis, parastomal hernia, separation, prolapse, retraction, and necrosis）, time to stoma closure, the degree of intra-abdominal adhesions, and postoperative complications after stoma reversal （e.g. incision infection, incisional hernia, and intestinal obstruction）. Results There were no significant differences in baseline data between the two groups （P>0.05）. The stoma suturing time, reversal operation time, and time to stoma closure in the observation group were significantly shorter than those in the control group （P<0.05）. The degree of intra-abdominal adhesions in the observation group was significantly lower than that in the control group （P<0.05）. However, there were no statistical differences between the two groups in the comparison of stoma related complications, incision infection, and intestinal obstruction after stoma reversal surgery （P>0.05）. The incidence of postoperative incisional hernia in the observation group was significantly lower than that in the control group （P<0.05）. Conclusion Compared with traditional suturing methods, the single-layer suturing technique can effectively shorten the stoma suturing and reversal operation time in rectal cancer anterior resection, and reduce the occurrence of intra-abdominal adhesions.
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