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

doi:10.16139/j.1007-9610.2023.01.13

Abstract

Abstract:

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.

Key words: Rectal cancer, Stoma, Simple support bracket, One stitch suture

CLC Number:

R735.37

HU Lei, XU Yalong, LIU Shaojun, HE Yiren, LIU Liu, ZHU Zhiqiang. Application of simple support bracket combined with one stitch suture in terminal ileostomy of rectal cancer[J]. Journal of Surgery Concepts & Practice, 2023, 28(01): 77-82.

Figures/Tables 4

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References 29

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Item	Control group	Study group	χ² value	P value
Age(year)
≥60	25(71.4%)	22(62.9%)	0.58	0.46
<60	10(28.6%)	13(37.1%)
Gender
Male	26(74.3%)	24(68.6%)	0.28	0.60
Female	9(25.7%)	11(31.4%)
Cardiovascular disease
Yes	12(34.3%)	11(31.4%)	0.06	0.80
No	23(65.7%)	24(68.6%)
Diabetes
Yes	4(11.4%)	1(2.9%)	1.94	0.16
No	31(88.6%)	34(97.1%)
TNM stage
Ⅰ	15(42.9%)	12(34.3%)
Ⅱ	13(37.1%)	18(51.4%)	1.47	0.48
Ⅲ	7(20.0%)	5(14.3%)

Item	Control group	Study group	t value	P value
First-stage operative time (min)	202.14±45.70	183.57±34.67	1.91	0.06
First-stage operative blood loss (mL)	59.03±11.49	54.11±10.30	1.88	0.06
First-stage ileostomy time(min)	22.66±3.64	13.77±2.02	3.22	<0.001
First-stage ileostomy blood loss (mL)	4.54±1.80	3.80±1.83	1.71	0.09
Postoperative stoma exhaust time (d)	2.63±0.49	2.37±0.69	1.80	0.08
First-stage total cost in hospital stay(Yuan)	44 728.46±5 223.62	42 057.98±4 938.69	2.20	0.03
Second-stage stoma closure time (min)	103.29±30.96	88.14±28.03	2.15	0.04
Second-stage stoma closure blood loss (mL)	25.86±8.24	17.94±9.83	3.65	0.001
First and second-stage total days in hospital stay (d)	17.34±4.57	14.54±2.32	3.23	0.002

Complication	Control group	Study group	χ² value	P value
Fecal dermatitis	4(11.4%)	3(8.6%)
Parastomal hernia	2(5.7%)	1(2.9%)
Stoma ischemia	2(5.7%)	0
Total	8(22.9%)	4(11.4%)	1.61	0.21