定义：造口是指有目的地在一段消化道与腹前壁皮肤之间构建吻合。最常用的造口涉及小肠远端(如，回肠造口术)和大肠(即，结肠造口术)。临床上可能需要临时或者永久转流粪便以处理多种病变，包括先天性异常、结肠梗阻、炎症性肠病、外伤性肠道破裂或胃肠恶性肿瘤。
Definition: An ostomy refers to the purposeful creation of an anastomosis between a segment of the digestive tract and the skin of the anterior abdominal wall. The most commonly used ostomies involve the distal part of the small intestine (e.g., ileostomy) and the large intestine (i.e., colostomy). Clinically, temporary or permanent fecal diversion may be required to manage a variety of conditions, including congenital abnormalities, colonic obstruction, inflammatory bowel disease, traumatic intestinal rupture, or gastrointestinal malignancies.
临床适应症（分场景）
临时造口：
·高风险吻合口保护：如低位结直肠吻合（距肛缘<5-7cm）、放疗后 /类固醇使用者 ；
·急症减压：远端结肠梗阻、肠穿孔（避免肠管破裂）；
·促进愈合：肛周脓毒症、肠瘘（如肠–阴道瘘）康复 。
永久造口：
·直肠癌腹会阴联合切除术后（无法保留肛门）；
·肛门功能完全丧失（如严重大便失禁）；
·肠道广泛切除无法重建连续性。
·Clinical Indications (by Scenario) Temporary Ostomy: – Protection of high-risk anastomoses: such as low colorectal anastomosis (distance from the anal verge <5-7 cm), post-radiotherapy/steroid users; – Emergency decompression: distal colonic obstruction, intestinal perforation (to avoid intestinal rupture); – Promotion of healing: recovery from perianal sepsis, intestinal fistulas (e.g.,enterovaginal fistula). Permanent Ostomy: – After abdominoperineal resection for rectal cancer (inability to preserve the anus); – Complete loss of anal function (e.g., severe fecal incontinence); – Extensive intestinal resection with inability to reconstruct continuity.
定位时机：择期手术术前 24-48小时，患者取坐位、站立位、仰卧位反复确认（避免体位变化导致位置偏移）。
禁忌区域：疤痕（血运差）、脐周（易渗漏）、髂前上棘（骨突摩擦装置）、腰带线（压迫造口）。造口位置与所有皱襞、皮褶、既往切口、腰带线、脐和骨性突起必须至少距离5cm，因为这些结构可能会干扰造口装置的贴合性。对于未进行术前造口标记的紧急手术，合理的造口部位是从髂前上棘到脐连线的2/3处。
Timing of localization: For elective surgery, 24-48 hours before the operation, the patient should be in a sitting, standing, and supine position to repeatedly confirm the location (to avoid position deviation caused by postural changes). Contraindicated areas: Scars (poor blood supply), periumbilical area (prone to leakage), anterior superior iliac spine (bony prominence may rub against the device), and waist belt line (may compress the stoma). The stoma location must be at least 5 cm away from all folds, skin creases, previous incisions, waist belt lines, umbilicus, and bony prominences, as these structures may interfere with the fit of the ostomy device. For emergency surgeries without preoperative stoma marking, a reasonable stoma site is at the 2/3 point of the line connecting the anterior superior iliac spine to the umbilicus.
具体定位点：
·回肠造口：右下腹，脐与髂前上棘连线中上1/3，或三点（脐、髂前上棘、耻骨联合）中线交点 ；
·横结肠造口：上腹部，脐与肋缘水平线之间；
·乙状结肠造口：左下腹，髂前上棘与脐连线中下部。
·Specific localization points: – Ileostomy: Right lower abdomen, at the upper middle 1/3 of the line connecting the umbilicus and the anterior superior iliac spine, or at the midline intersection of three points (umbilicus, anterior superior iliac spine, pubic symphysis); – Transverse colostomy: Upper abdomen, between the umbilicus and the horizontal line of the costal margin; – Sigmoid colostomy: Left lower abdomen, at the middle lower part of the line connecting the anterior superior iliac spine and the umbilicus.
分离需造口的肠段，保留足够的血供（注意肠系膜血管）。若为临时性造口，保留肠管连续性（如襻式造口）；若为永久性（如Miles术），则切断肠管。建议将肠管游离至可拉出腹部皮肤表面4CM，为后续造口做充分准备。环形切除直径 2 cm 的皮肤盘（肥胖者可扩大至2.5 cm），电刀垂直切开皮下脂肪至腹直肌前鞘，避免斜行通道（减少旁疝风险）。采用标准造口技术时，钻孔通常会横穿一条腹直肌，而理论上腹直肌可为造口提供额外的支持和稳定性。
Dissect the intestinal segment requiring stoma creation, and preserve adequate blood supply (pay attention to the mesenteric blood vessels). For a temporary stoma, maintain the continuity of the intestinal tube (such as a loop ostomy); for a permanent stoma (such as Miles operation), cut off the intestinal tube. It is recommended to free the intestinal tube until it can be pulled out 4 cm above the abdominal skin surface, so as to make sufficient preparations for the subsequent stoma creation. 1. Resect a skin disc with a diameter of 2 cm in a circular manner (it can be expanded to 2.5 cm for obese patients). Use an electric knife to vertically incise the subcutaneous fat to the anterior sheath of the rectus abdominis, avoiding an oblique channel (to reduce the risk of parastomal hernia). When using the standard stoma technique, the drilling usually traverses one rectus abdominis muscle, and theoretically, the rectus abdominis can provide additional support and stability for the stoma.
末端结肠造口的腹膜外隧道式构建被提出作为一种降低造口旁疝（PSH）风险的技术。腹膜外隧道式构建与显著更低的造口旁疝发生率和显著更低的造口脱垂发生率The extraperitoneal tunnel construction of end colostomy has been proposed as a technique to reduce the risk of parastomal hernia (PSH). The extraperitoneal tunnel construction is associated with a significantly lower incidence of parastomal hernia and a significantly lower incidence of stoma prolapse.
判断腹壁开口较大会增加造口旁疝的风险，而开口较小会导致缺血、狭窄、造口出口梗阻狭窄或造口坏死。皮肤和筋膜的开口应足够大，能够让选定的肠管穿过腹壁，而不会闭塞肠系膜血管和肠腔 在预定的造口位置，采用全层环状切口切开其上覆的皮肤。使用电刀环状切开皮下组织，清理腹直肌前筋膜上的附着物。在腹直肌前筋膜上做2cm的垂直或交叉的切口(“十字切口”)。对于回肠造口术和结肠造口术，采用2cm的垂直切口，以尽量减少筋膜破坏并可容两指顺利通过。结肠造口术经常需要较大的钻孔，以便肠管轻松通过腹壁、降低张力、避免缺血，并且尽量减轻静脉淤血。
It is judged that a larger abdominal wall opening will increase the risk of parastomal hernia, while a smaller opening may lead to ischemia, stenosis, obstruction or necrosis of the stoma outlet. The openings in the skin and fascia should be large enough to allow the selected intestinal segment to pass through the abdominal wall without occluding the mesenteric blood vessels and intestinal lumen. At the predetermined stoma site, make a full-thickness circular incision through the overlying skin. Use a scalpel or electrosurgical knife to make a circular incision in the subcutaneous tissue and clean the attachments on the anterior rectus fascia. Make a 2 cm vertical or cross incision (‘cruciate incision’) on the anterior rectus fascia. For ileostomy and colostomy, a 2 cm vertical incision is adopted to minimize fascial damage and allow two fingers to pass through smoothly. Colostomy often requires a larger opening to facilitate the intestinal segment to pass through the abdominal wall easily, reduce tension, avoid ischemia, and minimize venous congestion.
游离肠管 — 选择合适的肠段需要考虑多种因素，包括年龄、共存疾病、体型，以及粪便转流是永久性还是临时性。构建造口一定要选择血供良好的健康血管。在重度肥胖或广泛粘连的患者中预计会遇到困难。下列操作有助于按需充分游离大肠，以确保肠管能适当突出于腹壁、血供良好且与腹壁无张力对合，从而最大程度降低并发症的风险：
·构建降结肠造口时，完全游离脾曲
·在结肠系膜的基底处横断内侧腹膜附着
·离断左结肠动脉起始部近端的肠系膜下动脉，以减少栓系效应
·如果需要避免张力或回缩的风险，可在靠近造口的结肠系膜上开窗
修剪增厚的结肠系膜和过多的肠脂垂(脂肪附着物)，使肠管更容易通过腹壁，同时保留边缘动脉
Freeing the intestinal tube – Selecting an appropriate intestinal segment requires consideration of multiple factors, including age, comorbidities, body type, and whether the fecal diversion is permanent or temporary. For stoma construction, it is essential to choose healthy intestinal segments with good blood supply. Difficulties are expected in patients with severe obesity or extensive adhesions. The following operations help fully free the large intestine as needed to ensure that the intestinal tube can properly protrude from the abdominal wall, has good blood supply, and fits the abdominal wall without tension, thereby minimizing the risk of complications: The peritoneal attachments should be fully freed: – When constructing a descending colostomy, completely free the splenic flexure – Transect the medial peritoneal attachments at the base of the colonic mesentery – Divide the inferior mesenteric artery proximal to the origin of the left colic artery to reduce the tethering effect – If it is necessary to avoid the risk of tension or retraction, a window can be created in the colonic mesentery near the stoma Trim the thickened colonic mesentery and excessive epiploic appendages (fatty attachments) to facilitate the passage of the intestinal tube through the abdominal wall while preserving the marginal artery.
永久性造口建议进行分层缝合减少造口旁疝发生率。
预防性回肠袢式造口可将回肠浆膜层直接固定于皮下，使其突出于皮肤表面。对体型瘦小、严重腹水、预防性造口保留时间长者，建议进行分层缝合。
缝合前鞘与腹膜：3-0可吸收线缝合4针（3、6、9、12点），固定肠管浆肌层。（对于永久性肠造口临床实践中推荐进行肠管固定，以减少造口旁疝及造口脱垂的发生。可在肠管拖出前，在腹直肌前鞘及腹膜上预留6~8针，肠管拖出腹壁后用预留针进行固定肠管。行腹膜外隧道造口者，可仅将肠管及其系膜与腹直肌前鞘间断缝合固定。）
关于造口支撑棒使用的争议：ASCRS指南表明非肥胖患者无需常规使用造口支撑棒，若需支撑（如肠系膜短），选用软质导管（如红色尿管），术后5-7天拔除。
For permanent stomas, layered suturing is recommended to reduce the incidence of parastomal hernias. For preventive loop ileostomy, the serosal layer of the ileum can be directly fixed to the subcutaneous tissue to make it protrude from the skin surface. Layered suturing is recommended for patients with a thin build, severe ascites, or those requiring a long retention time of the preventive stoma. Suturing the anterior sheath and peritoneum: Use 3-0 absorbable sutures to place 4 stitches (at 3, 6, 9, and 12 o’clock positions) to fix the seromuscular layer of the intestinal tube. (In clinical practice for permanent intestinal stomas, it is recommended to fix the intestinal tube to reduce the occurrence of parastomal hernias and stoma prolapse. Before pulling out the intestinal tube, 6-8 reserved stitches can be placed on the anterior sheath of the rectus abdominis and the peritoneum. After the intestinal tube is pulled out of the abdominal wall, the reserved stitches are used to fix the intestinal tube. For extraperitoneal tunnel stomas, the intestinal tube and its mesentery can only be intermittently sutured and fixed to the anterior sheath of the rectus abdominis.) Controversies regarding the use of stoma support rods: The ASCRS guidelines indicate that stoma support rods are not routinely required for non-obese patients. If support is needed (e.g., due to a short mesentery), a soft catheter (such as a red rubber catheter) should be selected and removed 5-7 days after the operation.
小肠或结肠单腔造口的情况下直接打开肠壁进行造口缝合固定。对于回肠造口，在实施Brooke外翻后，要求造口至少要突出腹壁2-3cm，以便肠道内容物能充分排入造口袋 。相比之下，结肠造口排出的内容物更偏向于固体，故造口仅需突出于腹壁之上1-2cm。对于结肠造口，我们也会保证至少小幅度突出，以确保造口设备放置恰当且贴合性好。
In the case of a single-lumen stoma of the small intestine or colon, the intestinal wall is directly opened for stoma suturing and fixation. For an ileostomy, after performing the Brooke eversion, the stoma is required to protrude at least 2-3 cm from the abdominal wall to ensure that the intestinal contents can be fully discharged into the ostomy bag. In contrast, the contents discharged from a colostomy are more solid, so the stoma only needs to protrude 1-2 cm above the abdominal wall. For colostomies, we also ensure at least a small degree of protrusion to ensure proper placement and good adherence of the ostomy appliance.
对于腹壁较厚、肠系膜缩短、肥胖、患有克罗恩病，或存在神经内分泌肿瘤、硬纤维瘤的患者，可能难以将造口制作到理想的高度。尽管如此，在技术可行的情况下，应避免创建与皮肤齐平的造口。可用于增加造口长度的技术包括选择性肠系膜血管结扎、“端– 袢式” 造口术，以及为肥胖患者选择上腹部造口部位。
For patients with thick abdominal walls, shortened mesentery, obesity, Crohn’s disease, neuroendocrine tumors, or desmoid tumors, it may be difficult to create a stoma with the ideal height. Nevertheless, when technically feasible, a stoma that is flush with the skin should be avoided. Techniques that can be used to increase the length of the stoma include selective ligation of mesenteric blood vessels, ‘end-loop’ ostomy, and selection of an upper abdominal stoma site for obese patients.
外翻技术：3-0可吸收线间断缝合（全层肠壁+皮下组织），形成“玫瑰瓣”外翻。
黏膜边缘高出皮肤≥2cm，可降低造口回缩、渗漏等风险。(回肠建议高出至少2cm，结肠建议高出皮肤至少1cm)。
Eversiontechnique: Interrupted suturing with 3-0 absorbable sutures (full-thickness intestinal wall + subcutaneous tissue) to form a ‘rose petal’ eversion. The mucosal edge should be at least 2 cm above the skin, which can reduce the risks of stoma retraction, leakage, etc. (It is recommended that the ileostomy be at least 2 cm above the skin, and the colostomy be at least 1 cm above the skin).
将4根可吸收缝线等距安放在12、3、6、9点方向作为牵引线，使肠管附着于腹壁钻孔。不要将缝线打结，在缝线尾部用小血管钳做好标记以辅助外翻肠管。
构建回肠造口时，缝合时要结合Brooke外翻技术 ，即将缝线在肠管断端穿过肠壁全层，再于断端近端约3cm处穿过肠壁浆肌层，之后再穿过腹壁真皮层。
构建结肠造口时，缝线要穿过结肠断端的肠壁全层和腹壁的真皮层 ，但也可穿过浆肌层以保证造口充分外翻。
轻柔拉动缝线使肠管外翻，然后在恰当位置打结。如果打结缝线时肠管未能外翻，则在缝线针脚间轻轻按压浆肌层以完成外翻。
在最初的牵引线之间再放1-2根缝线，拉近远端肠壁全层与腹壁真皮。
Place 4 absorbable sutures at equal distances at the 12, 3, 6, and 9 o’clock positions as traction sutures to attach the intestinal tube to the abdominal wall opening. Do not tie the sutures; mark the tails of the sutures with small vascular forceps to assist in everting the intestinal tube. When constructing an ileostomy, the suturing should be combined with the Brooke eversion technique, that is, the suture passes through the full thickness of the intestinal wall at the stump of the intestinal tube, then passes through the seromuscular layer of the intestinal wall at about 3 cm proximal to the stump, and then passes through the dermal layer of the abdominal wall. When constructing a colostomy, the suture should pass through the full thickness of the intestinal wall at the colonic stump and the dermal layer of the abdominal wall, but it can also pass through the seromuscular layer to ensure sufficient eversion of the stoma. Gently pull the sutures to evert the intestinal tube, then tie the knots at the appropriate positions. If the intestinal tube fails to evert when tying the sutures, gently press the seromuscular layer between the suture stitches to complete the eversion. Place 1-2 more sutures between the initial traction sutures to approximate the full thickness of the distal intestinal wall to the dermal layer of the abdominal wall.
（袢式造口）的优势
1.可逆性强作为临时性造口，术后关闭造口的手术难度较低，对肠管损伤小，更容易恢复肠道连续性，患者后期生活质量更高。
2.手术操作相对简单无需切断肠管，手术时间短、创伤小，术后恢复较快，适合病情较急或身体状况较差的患者（如肠梗阻、肠穿孔术后需临时分流）。
3.护理便捷单开口设计，造口袋贴合更方便，减少粪便渗漏风险，患者适应和护理难度较低。
4.保护远端肠管效果好能有效分流粪便，避免远端肠管（如吻合口）受粪便刺激，降低感染、瘘管等并发症风险，促进愈合。
Advantages of Loop Ostomy 1. High reversibility: As a temporary ostomy, the operation for closing the stoma after surgery is less difficult, causes less damage to the intestinal tube, makes it easier to restore intestinal continuity, and improves the patient’s quality of life in the later period. 2. Relatively simple surgical operation: There is no need to cut the intestinal tube, the operation time is short, the trauma is small, and the postoperative recovery is relatively fast. It is suitable for patients with acute conditions or poor physical conditions (such as those needing temporary diversion after intestinal obstruction or intestinal perforation surgery). 3. Convenient care: The single-opening design makes it easier to fit the ostomy bag, reduces the risk of fecal leakage, and lowers the difficulty for patients to adapt and take care of it. 4. Good effect in protecting the distal intestinal tube: It can effectively divert feces, avoid the distal intestinal tube (such as anastomosis) from being irritated by feces, reduce the risk of complications such as infection and fistula, and promote healing.
回、结肠袢式造口术：低位直肠癌术后保护吻合口、高风险吻合口。例如曾接受过盆腔放疗的患者，使用的药物会妨碍伤口愈合的患者(如类固醇激素、免疫抑制剂或生物制剂)，或有低位结直肠吻合口的患者(吻合口距肛缘<5-7cm)
Loop ileostomy and loop colostomy: They are used to protect the anastomosis after low rectal cancer surgery and high-risk anastomoses. For example, patients who have received pelvic radiotherapy, patients taking drugs that may hinder wound healing (such as steroids, immunosuppressants or biological agents), or patients with low colorectal anastomoses (the anastomosis is <5-7 cm from the anal verge).
袢式回肠或结肠造口可采用去功能远端支构建，或者采用双腔造口。与远端支被压缩的袢式造口相比，双腔造口术构建的造口更大且更难管理(如泄漏)，如果将造口肠管拉出腹部开口后，造口可恰当地留在腹壁上，并且无张力或回缩，就可移除支撑管，造口即构建成功。如果难以将造口肠管拉出腹部开口，则可能需要额外的固定措施来支撑造口突出于腹壁之上。在这种情况下，可以用14Fr红色橡胶导管替代烟卷式引流管。红色橡胶导管呈大环状弯曲，用0号丝线固定成形。将肠的远端“罩”外翻并缝合到近端肢体上以形成一个喷口。
Loop ileostomy or colostomy can be constructed using a defunctionalized distal limb or as a double-barreled stoma. Compared with loop stomas where the distal limb is compressed, stomas constructed via double-barreled ostomy are larger and more difficult to manage (e.g., leakage). Once the stoma bowel segment is pulled through the abdominal opening, properly positioned on the abdominal wall without tension or retraction, the support tube can be removed, indicating successful stoma construction. If it is difficult to pull the stoma bowel segment through the abdominal opening, additional fixation measures may be required to support the stoma’s protrusion above the abdominal wall. In such cases, a 14Fr red rubber catheter can be used instead of a Penrose drain. The red rubber catheter is bent into a large loop and secured in shape with 0 silk sutures. The distal ‘hood’ of the bowel is everted and sutured to the proximal limb to form a spout.
造口步骤：
·拉出回肠袢（距回盲瓣30cm），用 14Fr 红色橡胶管（支撑棒）呈环状固定于腹壁（肠系膜短者使用，非肥胖者可省略 ）；
·切开远端肠袢（对系膜缘，占周长80%），近端肠管外翻；
·3-0 可吸收线将近端肠壁全层与皮肤缝合，远端 “去功能” 段固定于皮下（不外露）；
·支撑棒术后5-7天拔除。
·Stoma creation steps: Pull out the ileal loop (30cm away from the ileocecal valve), and fix it to the abdominal wall in a ring shape with a 14Fr red rubber tube (support rod) (used for those with a short mesentery, and can be omitted for non-obese patients); Incise the distal intestinal loop (on the anti-mesenteric border, accounting for 80% of the circumference), and evert the proximal intestinal tube; Suture the full thickness of the proximal intestinal wall to the skin with 3-0 absorbable sutures, and fix the distal ‘defunctionalized‘ segment under the skin (not exposed); The support rod is removed 5-7 days after the operation.
袢式回肠造口与袢式结肠造口的主要区别在于造口创建和后续关闭时的并发症发生率。一项荟萃分析评估了临时性转流的袢式回肠造口和袢式结肠造口，发现与袢式结肠造口相比，袢式回肠造口与造口脱垂或回缩的发生率显著降低和造口旁疝发生率显著降低相关，但与脱水发生率显著升高相关。造口皮炎、造口周围感染、造口出血和造口逆转相关发病率相同。袢式回肠造口关闭后术后肠梗阻显著更常见，而袢式结肠造口逆转后手术部位感染或切口疝显著更常见。
与结肠造口患者相比，袢式回肠造口患者可能具有更好的生活质量，因为气味更少、因脱垂而调整衣物的需求更少以及造口护理更容易。
The main difference between loop ileostomy and loop colostomy lies in the incidence of complications during stoma creation and subsequent closure. A meta-analysis evaluating temporary diverting loop ileostomies and loop colostomies found that, compared with loop colostomies, loop ileostomies were associated with a significantly lower incidence of stoma prolapse or retraction and a significantly lower incidence of parastomal hernia, but with a significantly higher incidence of dehydration. The incidences of stomal dermatitis, peristomal infection, stoma bleeding, and stoma reversal-related morbidity were similar. Postoperative intestinal obstruction was significantly more common after loop ileostomy closure, while surgical site infection or incisional hernia was significantly more common after loop colostomy reversal. Patients with loop ileostomies may have a better quality of life compared with those with colostomies, due to less odor, less need to adjust clothing because of prolapse, and easier stoma care.
非肥胖患者中，构建袢式回肠造口时无需常规使用支撑棒。
2006 年，一项小型随机对照试验比较了使用刚性支撑棒与不使用支撑棒制作的回肠造口，表明造口回缩率没有显著差异。对这些研究的荟萃分析发现造口回缩率没有差异；然而，使用支撑棒的患者造口坏死、造口周围皮炎和黏膜皮肤分离的发生率显著更高。上述研究中的平均体重指数范围为19.5 至26.2 kg/m2。如果使用支撑棒，柔性版本（如红色橡胶导管）可能便于造口器具的安装和更换。
In non-obese patients, routine use of a support rod is not required when constructing a loop ileostomy. In 2006, a small randomized controlled trial comparing ileostomies created with rigid support rods versus without support rods showed no significant difference in the rate of stoma retraction. A meta-analysis of these studies also found no difference in stoma retraction rates; however, patients who used support rods had a significantly higher incidence of stoma necrosis, peristomal dermatitis, and mucocutaneous separation. The average body mass index in the aforementioned studies ranged from 19.5 to 26.2 kg/m². If a support rod is used, a flexible version (such as a red rubber catheter) may facilitate the application and replacement of ostomy appliances.
关闭造口时，与其他技术相比，荷包缝合皮肤关闭具有优势。
传统上，造口关闭伤口不缝合，任其二期愈合，因为手术部位感染的风险高达41%。关闭技术包括一期关闭、延迟一期关闭、二期关闭、负压伤口治疗、包含引流管的关闭和荷包缝合关闭。
在一项荟萃分析中，包括1812 名接受造口逆转的患者（826 名荷包缝合关闭vs 986 名一期关闭），荷包缝合关闭患者的手术部位感染率显著低于一期关闭患者。两组的住院时间、疝发生率和手术时间相似。两组的切口疝发生率、住院时间或手术时间没有显著差异。荷包缝合关闭的患者对美容结果的满意度更高，手术部位感染率显著更低。
When closing a stoma, the purse-string suture technique for skin closure offers advantages over other methods. Traditionally, stoma closure wounds were left unsutured to heal by secondary intention, as the risk of surgical site infection (SSI) could be as high as 41%. Closure techniques include primary closure, delayed primary closure, secondary closure, negative pressure wound therapy, closure with drainage tubes, and purse-string suture closure. In a meta-analysis involving 1,812 patients undergoing stoma reversal (826 with purse-string closure vs. 986 with primary closure), the rate of surgical site infection was significantly lower in patients with purse-string closure compared to those with primary closure. The length of hospital stay, incidence of hernia, and operative time were similar between the two groups. There were no significant differences in the incidence of incisional hernia, length of hospital stay, or operative time between the two groups. Patients with purse-string closure reported higher satisfaction with cosmetic outcomes and a significantly lower rate of surgical site infection.
腹腔镜手术的优势包括疼痛和麻醉需求减少、住院时间缩短、肠道功能恢复更早以及总体并发症少于开腹手术。腹腔镜方法的使用率每年增加2.8%，同时开腹手术从100% 减少到74.2%。腹腔镜结肠造口的并发症少于开腹手术患者，住院时间更短.在预先选定的造口部位安置一个12mm的操作孔。检视整个腹腔。如果确认可以手术，则在耻骨弓上方和左髂窝处(髂前上棘上方和内侧各两指宽处)分别再安置1个5mm的操作孔。如果粘连使术者难以看见并接近造口肠段，则可中转剖腹手术。类似的方法也可用于乙状结肠袢式或端式造口，但其外侧操作孔应位于回肠袢式造口操作孔的镜像位置。
The advantages of laparoscopic surgery include reduced pain and anesthesia requirements, shorter hospital stays, earlier recovery of intestinal function, and fewer overall complications compared with open surgery. The utilization rate of laparoscopic methods increases by 2.8% annually, while the rate of open surgery decreases from 100% to 74.2%. Patients undergoing laparoscopic colostomy have fewer complications and shorter hospital stays than those undergoing open surgery. A 12mm port is placed at the pre-selected stoma site. The entire abdominal cavity is inspected. If the operation is confirmed to be feasible, an additional 5mm port is placed above the pubic arch and in the left iliac fossa (two finger-widths above and medial to the anterior superior iliac spine) respectively. If adhesions make it difficult for the surgeon to visualize and access the stoma bowel segment, conversion to laparotomy may be performed. A similar approach can be used for sigmoid loop or end colostomy, but the lateral port should be placed at the mirror position of the port for loop ileostomy.
医生介绍
赵立刚
普外科医生
副主任医师
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赵立刚医生凭借深厚的医学造诣与丰富的临床经验，在普通外科领域声誉卓著。加入和睦家医疗团队前，赵医生就职于火箭军特色医学中心普通外科，长期致力于攻克各类外科难题。
在疾病诊疗方面，赵立刚医生展现出卓越的专业能力，尤其擅长甲状腺肿瘤、乳腺肿瘤、腹壁疝、胃肠道肿瘤、胆囊结石、肝囊肿、急腹症，以及肛肠疾病的治疗。在手术操作上，赵医生技艺精湛，能够出色完成甲状腺手术、乳腺肿瘤切除术、腔镜下腹壁疝修补术、腹腔镜下阑尾切除术、腹腔镜消化道穿孔修补术，以及腹腔镜辅助胃肠道肿瘤切除术，凭借细腻的操作与出色的手术效果，赢得患者的广泛赞誉。
在学术研究领域，赵立刚医生同样成果丰硕。他发表了10余篇国内外学术论文，参与编写3部医学论著，还成功申请3项专利，凭借深厚的学术积累与不断探索的精神，为推动行业进步贡献了重要力量。
北京和睦家医院（将台院区）
普通外科 门诊：
每周一、周三、周四