关键词: 直肠癌, 会阴切口重建, 肠造口关闭术, 十字缝合法, 安全性

Abstract: Objective To analyze the effect and safety of “cross” suture in the reconstruction of perineal incision and closure of enterostomy for rectal cancer. Methods A total of 107 patients with perineal incision reconstruction during combined abdominal perineal resection and abdominal incision reconstruction during enterostomy closure treated in our hospital from January 2019 to January 2022 were selected.They were divided into traditional stoma group (12 cases),stoma “cross” group (14 cases),traditional reconstruction group (37 cases) and reconstruction “cross” group (44 cases).Follow up for 30 days after operation to compare the effects of each group. Results The operation time,incision healing time,postoperative extubation time,and postoperative hospital stay in the ostomy “cross” group and the reconstruction “cross” group were shorter than those in the traditional ostomy group and the reconstruction traditional group,and the intraoperative blood loss was less than that in the traditional ostomy group and the reconstruction traditional group (P<0.05).The NRS score of the “cross group” and the  reconstruction“cross group” 1,2 and 3 days after surgery was lower than that of the traditional group and the traditional reconstruction group (P<0.05).The color,thickness,blood vessels,softness and total score of postoperative incision in the “cross group” and the reconstruction“cross group” were lower than those in the traditional group and the traditional reconstruction group (P<0.05).The incidence of postoperative complications in the reconstruction “cross” group was 6.82%,significantly lower than that in the traditional reconstruction group (24.32%) (P<0.05).There was no difference in the total incidence of complications between the traditional stoma group and the stoma “cross” group (P>0.05). Conclusion “Cross” suture can be used for incision reconstruction during combined abdominal perineal resection and enterostomy closure.It has the characteristics of “unobstructed drainage” and “reduced tension suture”,and can reduce the incidence of postoperative complications.

Key words: rectal cancer, perineal incision reconstruction, enterostomy closure, cross seam method, security