Aberg Hanna, Påhlman Lars, Karlbom Urban
Department of Surgical Sciences, Section of Surgery, University Hospital, 751 85, Uppsala, Sweden.
Int J Colorectal Dis. 2007 Jun;22(6):637-42. doi: 10.1007/s00384-006-0215-5. Epub 2006 Nov 15.
The reported risk of small-bowel obstruction (SBO) after major abdominal surgery varies. The aim of this study was to study frequency and risk factors of SBO after ileal pouch-anal anastomosis for ulcerative colitis.
Review of the medical records of 188 patients operated with restorative proctocolectomy between 1985 and 1997. All admissions to the hospital were registered and symptoms and X-ray findings consistent with ileus were analysed in relation to preoperative and operative data.
SBO was the dominating cause of hospitalization. Forty-eight patients (25.5%) had developed SBO after a median of 76 (range 6-196) months of follow-up, of whom 26 were operated on. The cause of obstruction was adhesion in all but one patient. Early obstruction events were common and accounted for 27% of all operations. Twenty-five of 26 patients who were operated on had a diverting loop-ileostomy compared to 111/162 in the not-operated-on group (p < 0.01). In total, 696 days were spent at the hospital because of SBO.
SBO is common following pouch surgery and is the dominating cause of hospitalization postoperatively. About 25% of patients developed SBO and half of them needed surgery. The use of a diverting loop-ileostomy was related to an increased risk of surgery for SBO.
据报道，腹部大手术后小肠梗阻（SBO）的风险各不相同。本研究的目的是探讨溃疡性结肠炎行回肠储袋肛管吻合术后SBO的发生率及危险因素。
回顾1985年至1997年间188例行保留性直肠结肠切除术患者的病历。记录所有住院情况，并分析与肠梗阻相符的症状和X线检查结果与术前及手术数据的关系。
SBO是住院的主要原因。48例患者（25.5%）在中位随访76个月（范围6 - 196个月）后发生SBO，其中26例接受了手术。除1例患者外，所有梗阻原因均为粘连。早期梗阻事件很常见，占所有手术的27%。接受手术的26例患者中有25例行转流袢回肠造口术，而未接受手术的162例患者中有111例（p < 0.01）。因SBO住院总天数为696天。
储袋手术后SBO很常见，是术后住院的主要原因。约25%的患者发生SBO，其中一半需要手术。转流袢回肠造口术的使用与SBO手术风险增加有关。
