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[克罗恩病和溃疡性结肠炎患者回肠造口术的长期并发症]

[The long-term complications from ileostomy in patients with Crohn's disease and ulcerative colitis].

作者信息

Scaglia M, Delaini G G, Hultén L

机构信息

I Divisione di Chirurgia Generale, Ospedale Maria Vittoria, Torino.

出版信息

Chir Ital. 1992 Sep-Dec;44(5-6):211-22.

PMID:1344145
Abstract

In the period between 1959 and 1984 at the Surgery Department of the University of Goteborg, ileostomy (after colectomy) was mad in 203 patients affected by chronic inflammatory bowel disease. Patients were followed up prospectively to evaluate the frequency and severity of the complications. The cumulative rate of surgical reoperation was significantly higher in the group of patients with Crohn disease in comparison with those affected by ulcerative colitis. After 8 years it reached 75% in the first group and only 44% in the second. The most frequent indication for surgery reoperation were stenosis and retraction. 83% of the operations were only local not requiring laparotomy. No statistically significant correlation was found for the reoperation rate, the surgical technique, the length of the ileal resection and the post-operative weight gain. Only a systematic and accurate follow-up done by the surgeon and the enterostomist can detect an optimal functioning of the ileostomy. In case of complications which could be surgically corrected an early operation is needed. In most cases this can be simply made by local anesthesia.

摘要

1959年至1984年期间,在哥德堡大学外科,203例慢性炎症性肠病患者(结肠切除术后)接受了回肠造口术。对患者进行前瞻性随访,以评估并发症的发生率和严重程度。与溃疡性结肠炎患者相比,克罗恩病患者组的手术再手术累积率显著更高。8年后,第一组达到75%,第二组仅为44%。手术再手术最常见的指征是狭窄和回缩。83%的手术仅为局部手术,无需开腹。再手术率、手术技术、回肠切除长度和术后体重增加之间未发现统计学上的显著相关性。只有外科医生和造口治疗师进行系统、准确的随访,才能发现回肠造口术的最佳功能。对于可通过手术纠正的并发症,需要尽早手术。在大多数情况下,这可以通过局部麻醉简单完成。

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