Effect observation of horizontal mattress plication suture combined with grooved drainage tube drainage in the closure of prophylactic terminal ileostomy for rectal cancer patients
JIANG Guochao
WANG Mingjun
LI Yunpeng
CUI Shuqing
ZHANG Qingsong
DAI Shilong
Abstract：Objective To observe the effect of horizontal pad folding and suture of abdominal incision combined with subcutaneous contralateral drainage of grooved drainage tube in the closure of prophylactic terminal ileostomy for rec-tal cancer patients.Methods Totally 119 patients who underwent prophylactic terminal ileostomy reduction operation for rectal cancer were divided into the control group of 56 cases and observation group of 63 cases according to different sur-gical methods.In the control group,patients underwent traditional stratified intermittent suture for abdominal incision and routine drainage with single rubber sheet.In the observation group,patients underwent abdominal incision and horizontal mattress folding suture combined with subcutaneous contralateral drainage with grooved drainage tube.Data were collected on operative time,intraoperative blood loss,time to first postoperative flatus,postoperative visual analog scale(VAS)pain scores,and incidences of postoperative wound infection and incisional hernia in both groups.Kaplan-Meier risk func-tion curves were constructed to compare cumulative risks of wound infection and incisional hernia between these two groups.Univariate and multivariate Cox proportional hazards regression models were employed to identify independent fac-tors influencing postoperative wound infection and incisional hernia.Results No statistically significant differences were observed in operative time,intraoperative blood loss,postoperative time to first flatus,and pain scores on postoperative day 1 between the two groups(all P>0.05).The observation group demonstrated lower incidences of postoperative wound infection and incisional hernia as compared with the control group(all P<0.05).Kaplan-Meier risk function curve analy-sis revealed that the observation group had lower risks of postoperative wound infection and incisional hernia than the con-trol group.Cox multivariate analysis identified that preoperative chemoradiotherapy was independent risk factor for wound infection(HR=10.223,95%CI:2.033-51.407),while modified surgical procedure served was a protective factor(HR=0.071,95%CI:0.016-0.319),with all P<0.05.Smoking was identified as an independent risk factor for incisional her-nia(HR=5.147,95%CI:1.329-19.927),and modified surgical procedure was a protective factor(HR=0.088,95%CI:0.011-0.695;all P<0.05).Conclusion The horizontal mattress plication suture of abdominal incision combined with subcutaneous contralateral drainage of grooved drainage tube in the closure of prophylactic terminal ileostomy for rectal can-cer patients demonstrates effectiveness in reducing postoperative surgical site infection and incisional hernia rates,thereby preventing wound-related complications.
Keywords：radical resection for rectal cancerterminal ileostomy closurehorizontal mattress plication suturegrooved drainage tubesurgical site infectionincisional hernia
Publication Date：2025-02-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 56-61 )