关键词: 改道性结肠炎, 　直肠癌, 　回肠造瘘术, 　并发症

Abstract:

Objective　To investigate the occurrence, clinical symptoms and colonoscopy characteristics of diversion colitis after rectal cancer, so as to improve the clinical understanding of it.  Methods　The clinical symptoms and endoscopic data of 89 cases and 375 cases with or without protective ostomy after rectal cancer surgery were retrospectively analyzed.　Results　In the ostomy group, 30 cases showed the clinical symptoms of diversion colitis, and the incidences of abdominal pain, excreting mucus or mucous bloody stools were14.6%, 23.6% and 12.4% respectively, which were all higher than those without ostomy 2.9% 5.1% and 1.9% respectively (P<0.05). The positive rates of erythema swelling, erosion and ulcers, inflammatory follicular hyperplasia, inflammatory polyps and anastomotic stenosis in ostomy group were 93.3%，29.2%，15.7%，29.2%，15.7% respectively, significantly higher than those without ostomy (14.1%, 7.5%, 0.5%, 6.7% and 4.5% respectively). However, the absolute count of CD3+ (980±475) / μl, CD4+ (550±243) / μl, CD8+ (342±206) / μl, and CD4+ / CD8+ ratio (1.94±1.44) in ostomy group showed no statistical difference when compared with those without ostomy (P>0.05).　Conclusion　Diversion colitis has a high incidence in about 3 months after colorectal diversion. Endoscopy enables early clinical diagnosis of the disease for early symptomatic treatment.

Key words: Diversion colitis, 　Rectal cancer, 　Ileostomy, 　Complication