Clinical Value Of Prophylactic Ileal Y-type Stoma In Protecting The High Risk Factors Of Intestinal Fistula

Objective:To compare the clinical efficacy indexes of prophylactic ileum Y-type stoma and traditional loop ileum Y-type stoma in patients with high risk factors of intestinal fistula,and to explore the clinical application value of prophylactic ileum Y-type stoma in the protection of high risk factors of intestinal fistula.Methods:Were retrospectively analyzed in October 2019 to October 2020,the author treated in the hospital department of 52 cases with intestinal fistula of risk factors and preventive surgery boc fistula,postoperative marked line secondary colostomy HaiNa patients clinical data,according to the different divided into preventive ileum Y type of surgical procedure colostomy group(25 cases,observation group)and traditional loops ileum colostomy group(27 cases,Control group),and compared the following data between the two groups:1.General information:gender,age,high risk factors of intestinal fistula;2.Indicators of primary surgery:operative time,intraoperative blood loss,postoperative ventilation time,loss of digestive fluid,length of stay,and hospitalization cost;3.Indicators of the second repayment operation:operative time,intraoperative blood loss,postoperative ventilation time,length of stay,hospitalization cost,and time between repayment;4.Complications after primary surgery:early intestinal obstruction,incision infection,anastomotic fistula,stoma complications,and overall complications;5.Complications after the second repayment:early intestinal obstruction,incision infection,anastomotic fistula,incision hernia,and general complications;The above data were statistically analyzed to explore the clinical application value of prophylactic ileal Y-type stoma in protecting the high risk factors of intestinal fistula.Results:Among the 52 patients in this study,there were 44 males(84.6%)and 8 females(15.4%),aged(13-84)years old,with an average age of(56.75±16.14)years old.Patients with high risk factors of intestinal fistula:There were 8 cases of low rectal tumor,14 cases of traumatic colonic rupture with severe abdominal infection,9 cases of rectal cancer underwent neoadjuvant chemoradiotherapy before operation,10 cases of rectal cancer complicated with diabetes,and 11 cases of colon cancer complicated with severe malnutrition.一.After comparative analysis of the case data of the two groups,the results were statistically significant(P<0.05)as follows::1.Indicators of primary surgery:length of stay,hospitalization cost and postoperative intestinal fluid loss.Compared with the traditional loop ileotomy group,the prophylactic ileotomy Y-type fistula group had shorter hospital stay,lower hospitalization cost and less postoperative intestinal fluid loss.2.Indexes of secondary payment surgery:operative time,intraoperative blood loss,postoperative ventilation time,length of stay,and hospitalization cost.Compared with the traditional loop ileotomy group,the prophylactic ileotomy Y-type fistula group had shorter operative time and length of stay,less intraoperative blood loss,earlier postoperative ventilation time,and lower hospitalization cost.3.First postoperative complications:overall complications.The incidence of overall complications in the prophylactic ileum Y-type stoma group was lower than that in the traditional loop ileum Y-type stoma group.4.Postoperative complications:Early postoperative intestinal obstruction and general complications.The incidence of early intestinal obstruction and general complications in the prophylactic ileum Y-type ileostomy group was lower than that in the traditional loop ileostomy group.二.After comparative analysis of the case data of the two groups,there was no statistical difference in the results(P>0.05):1.General data:gender(P=0.615),age(P=0.897),high risk factors of intestinal fistula(P=0.381);2.Indices of primary surgery:operative time(P=0.090),intraoperative blood loss(P=0.104),postoperative ventilation time(P=0.085);3.Indexes of secondary reduction surgery:time between reduction surgery(P=0.613);4.Primary postoperative complications:early intestinal obstruction(P=0.107),incision infection(P=0.738),anastomotic fistula(P=0.738),and ostomy complications(P=0.659);Postoperative complications:incision infection(P=1.000),anastomotic fistula(P=1.000),incisional hernia(P=1.000).Conclusion:The prophylactic ileum Y-type stoma has the advantages of short hospitalization time,low hospitalization cost and controllability,which can reduce the difficulty of surgery for second payment and the incidence of postoperative complications.Therefore,it is worthy of promotion and application in clinical practice.