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袢式回肠造口术:技术要点与并发症

Loop ileostomy: technical aspects and complications.

作者信息

Carlsen E, Bergan A B

机构信息

Surgical Department B, National Hospital, Oslo, Norway.

出版信息

Eur J Surg. 1999 Feb;165(2):140-3; discussion 144. doi: 10.1080/110241599750007324.

Abstract

OBJECTIVE

To study the incidence of complications of construction and closure of loop ileostomies and the final outcome for the patients.

DESIGN

Retrospective study.

SETTING

University hospital, Norway.

SUBJECTS

100 patients with 103 loop ileostomies, operated on between 1980 and 1990.

MAIN OUTCOME MEASURES

Number of complications after ileostomy construction and closure.

RESULTS

7 required re-operation after construction of the loop ileostomy and 11 after its closure. The most common cause was small intestinal obstruction (4 after construction and 6 after closure). 2 developed stomal necrosis. The mean duration of hospital stay was 13 and 10 days for primary and secondary loop ileostomy, respectively, and the mean time before closure was 31 weeks. After closure another 6 developed leaks from the ileal anastomosis that required further operation. Patients with secondary loop ileostomies had their stomas significantly longer than those with primary loop ileostomies (21 compared with 43 weeks, p = 0.00005).

CONCLUSION

Despite the number of complications, we think that faecal diversion is still justified in complex pelvic surgery and we should try to reduce the complication rate further.

摘要

目的

研究袢式回肠造口术构建及关闭的并发症发生率以及患者的最终结局。

设计

回顾性研究。

地点

挪威大学医院。

研究对象

1980年至1990年间接受手术的100例患者,共103个袢式回肠造口。

主要观察指标

回肠造口术构建及关闭后的并发症数量。

结果

7例在袢式回肠造口术构建后需要再次手术,11例在造口关闭后需要再次手术。最常见的原因是小肠梗阻(构建后4例,关闭后6例)。2例发生造口坏死。初次和二次袢式回肠造口术的平均住院时间分别为13天和10天,关闭前的平均时间为31周。关闭后另有6例回肠吻合口出现渗漏,需要进一步手术。二次袢式回肠造口术患者的造口留置时间明显长于初次袢式回肠造口术患者(分别为21周和43周,p = 0.00005)。

结论

尽管存在并发症,但我们认为在复杂的盆腔手术中粪便转流仍然是合理的,我们应努力进一步降低并发症发生率。

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