Damjanovich László, Bartha Iván, Balázs György, Lukács Géza
Debreceni Egyetem Orvos- és Egészségtudományi Centrum I. Sebészeti Klinika, 4012 Debrecen.
Magy Seb. 2003 Aug;56(3-4):113-5.
The authors analyzed their data of the last three and a half years about patients with temporary loop ileostomy. We formed 18 ileostomies in patients with rectum carcinoma where the anastomosis was performed in the mid or lower rectum. Ten ileostomies were formed because of anastomotic leak, eight to protect the anastomosis, although there were no signs of insufficiency at the time of the intraoperative testing. Sixteen of the 18 patients had no complications. There were two complications in connection with ileostomies, these stomas were closed earlier than usual. Two other patients needed permanent stomas. Fourteen ileostomies were reversed without complications after 6-8 weeks. Two patients with local septic complications, following the closure, were treated conservatively. No reoperations were needed because of anal incontinence or anastomotic stenosis. We consider loop ileostomy safe with low morbidity, it can prevent diffuse peritonitis and/or a permanent stoma. Its routine use is recommended in patients with "ultra low" anastomoses and in cases where the intraoperative air test is positive.
作者分析了过去三年半中有关临时袢式回肠造口术患者的数据。我们为直肠癌患者做了18例回肠造口术,这些患者的吻合口位于直肠中下段。10例造口是因为吻合口漏,8例是为了保护吻合口,尽管术中检测时并无吻合口漏的迹象。18例患者中有16例无并发症。有2例与回肠造口术相关的并发症,这些造口比平常更早关闭。另外2例患者需要永久性造口。14例回肠造口术在6 - 8周后顺利还纳,无并发症。2例关闭造口后出现局部感染并发症的患者接受了保守治疗。未因肛门失禁或吻合口狭窄而需要再次手术。我们认为袢式回肠造口术安全,发病率低,它可预防弥漫性腹膜炎和/或永久性造口。对于“超低位”吻合的患者以及术中通气试验阳性的情况,建议常规使用。