肠造口在低位直肠癌治疗中的现状与展望

Intestinal stoma for low rectal cancer: current status and future perspectives

  • 摘要: 肠造口技术直接影响低位直肠癌患者的术后恢复与长期生活质量,其合理应用已成为外科治疗的重要环节。文章系统梳理了预防性回肠造口、结肠造口等主流术式的特点,并重点分析了为减少并发症而开展的改良技术,诸如无支撑棒造口、自闭式保护性造口以及腹膜外隧道造口的应用潜力与技术挑战。并进一步探讨了当前临床实践中关于造口指征、还纳时机选择等方面的争议。最后,结合当前微创外科与精准治疗的发展趋势,展望了包括可降解支架、经肛引流等创新技术在未来造口治疗中的应用前景,旨在为临床个体化诊疗方案的制定提供循证参考。

     

    Abstract: The technique of intestinal stoma formation plays a critical role in determining postoperative recovery and long-term quality of life for patients with low rectal cancer, making its appropriate application a vital component of surgical treatment. This article systematically reviews the characteristics of mainstream stoma techniques, such as protective ileostomy and colostomy, with a particular focus on modified approaches—including stoma creation without a supporting rod, self-closing protective stoma, and extraperitoneal tunnel stoma—that aim to lower complication rates. It also assesses the potential applications and technical challenges associated with these modifications. The article further addresses current clinical debates concerning stoma indications and the optimal timing for stoma reversal. Finally, in line with ongoing trends toward minimally invasive and precision surgery, the article looks ahead to the potential role of innovative technologies—for instance, biodegradable stents and transanal drainage—in the future management of stomas. The overarching objective is to offer an evidence-based reference to support the development of individualized clinical treatment strategies.

     

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