结肠造口回纳术与回肠造口回纳术相关并发症的比较。

A comparison of complications associated with colostomy reversal versus ileostomy reversal.

作者信息

Bell Christopher, Asolati Massimo, Hamilton Elizabeth, Fleming Jason, Nwariaku Fiemu, Sarosi George, Anthony Thomas

机构信息

Surgical Service, Dallas VA Medical Center, MC 112, 4500 Lancaster Road, Dallas, TX 75216, USA.

出版信息

Am J Surg. 2005 Nov;190(5):717-20. doi: 10.1016/j.amjsurg.2005.07.009.

DOI:10.1016/j.amjsurg.2005.07.009

PMID:16226946

Abstract

BACKGROUND

The incidence of complications after reversal of Hartmann's procedure is unknown. This study compares the morbidity of Hartmann's reversal versus loop ileostomy reversal.

METHODS

Two groups of 20 patients were studied retrospectively over a 5-year period. One group underwent Hartmann's takedown, and the other underwent loop ileostomy takedown. Postoperative complications were compared between the 2 groups.

RESULTS

Similar demographics were noted between each group. The most common initial indications for Hartmann's procedure were diverticulosis (11 patients, 55%) and colon cancer (4 patients, 20%). For patients who had undergone colectomy with primary anastomosis and ileostomy, colon cancer was the most common indication (12 patients, 60%) followed by diverticulosis (3 patients, 15%). Complications were more common after Hartmann reversal than loop ileostomy reversal (16 complications/11 patients versus 6 complications/4 patients, P = .047).

CONCLUSION

Segmental colonic excision with anastomosis and loop ileostomy may be an attractive alternative to minimize morbidity with stoma reversal.

摘要

背景

哈特曼手术逆转术后并发症的发生率尚不清楚。本研究比较了哈特曼手术逆转与袢式回肠造口术逆转的发病率。

方法

回顾性研究两组各20例患者，为期5年。一组接受哈特曼手术回纳，另一组接受袢式回肠造口术回纳。比较两组术后并发症情况。

结果

两组患者的人口统计学特征相似。哈特曼手术最常见的初始指征是憩室病（11例，55%）和结肠癌（4例，20%）。对于接受了结肠切除术并进行一期吻合和回肠造口术的患者，结肠癌是最常见的指征（12例，60%），其次是憩室病（3例，15%）。哈特曼手术逆转术后的并发症比袢式回肠造口术逆转术后更常见（16例并发症/11例患者对6例并发症/4例患者，P = 0.047）。