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术后第10天关闭小肠造口。

Closure of small bowel stomas on postoperative day 10.

作者信息

Menegaux Fabrice, Jordi-Galais Pere, Turrin Nicolas, Chigot Jean-Paul

机构信息

Department of General and Digestive Surgery, University Hospital Pitié-Salpêtrière, Paris, France.

出版信息

Eur J Surg. 2002;168(12):713-5. doi: 10.1080/00000000000000008.

Abstract

OBJECTIVE

To find out if early closure of a defunctioning small bowel stoma (day 10) was feasible and safe.

DESIGN

Prospective non-randomised study.

SETTING

University hospital, France.

INTERVENTIONS

During a 42-month period (January 1998-June 2001), all patients with a temporary small bowel stoma were elected for early closure on postoperative day 10 in a non-randomised prospective study. The procedure was considered only if the patient was not taking steroids, was in good condition, and had not developed wound or general sepsis after the initial operation. Other patients' stomas were closed after the usually recommended delay (>8 weeks).

MAIN OUTCOME MEASURES

Postoperative complications, delay to recover bowel activity, and to resume oral feeding, and duration of hospital stay.

RESULTS

Thirty-six patients were included in the study: 14 patients in the early group and 22 in the delayed group. There were no postoperative deaths. Three patients developed wound abscesses, two in the early group and one in the delayed group. The median (range) duration of hospital stay was longer in the delayed group: 36 (14-84) days, than in the early group: 22 (18-29) days (p < 0.01).

CONCLUSIONS

Small bowel stomas can be closed in selected healthy patients on postoperative day 10 without major complications.

摘要

目的

探讨小肠失功能造口早期关闭(术后第10天)是否可行及安全。

设计

前瞻性非随机研究。

地点

法国大学医院。

干预措施

在42个月期间(1998年1月至2001年6月),在一项非随机前瞻性研究中,所有有临时小肠造口的患者均在术后第10天被选择进行早期关闭。仅当患者未服用类固醇、身体状况良好且初次手术后未发生伤口或全身性感染时才考虑进行该手术。其他患者的造口在通常建议的延迟时间(>8周)后关闭。

主要观察指标

术后并发症、恢复肠道活动和恢复经口进食的延迟时间以及住院时间。

结果

36例患者纳入研究:早期组14例,延迟组22例。术后无死亡病例。3例患者发生伤口脓肿,早期组2例,延迟组1例。延迟组的住院时间中位数(范围)长于早期组:分别为36(14 - 84)天和22(18 - 29)天(p < 0.01)。

结论

在术后第10天,可对选定的健康患者关闭小肠造口,且无重大并发症。

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