Post S, Schürmann G, Herfarth C
Chirurgische Universitätsklinik Heidelberg.
Chirurg. 1991 Apr;62(4):306-13.
Indications, technique and prognosis of 129 enterostomies in Crohn's disease are reported. Advanced perianal or entero-genital fistulas represented the predominant indication (60% of primary, 46% of repeated stomas). 85% of stomas were created in combination with intestinal resections. Preferred type of stoma was a loopileostomy (76% of primary stomas), whereas colostomies were avoided whenever possible because of increased complications. Patients initially presenting with rectal involvement or perianal fistulas were prone to need a stoma during the course of their disease while intraabdominal fistulas, abscesses, age, sex, and longstanding disease where of no prognostic significance. Up to now 50% of all temporary stomas and a third of those created for distal fistulas could be closed. The chance of closure increased significantly with duration of symptoms less than 7 years, not more than one previous operation or absence of rectal involvement.
报告了129例克罗恩病肠造口术的适应证、技术及预后情况。晚期肛周或肠-生殖器瘘是主要适应证（占初次造口的60%，再次造口的46%）。85%的造口是在肠道切除的同时进行的。首选的造口类型是袢式回肠造口术（占初次造口的76%），而由于并发症增多，尽可能避免行结肠造口术。最初表现为直肠受累或肛周瘘的患者在病程中更容易需要造口，而腹腔内瘘、脓肿、年龄、性别及病程长短对预后无显著意义。截至目前，所有临时造口中有50%以及为远端瘘行造口的患者中有三分之一的造口可以关闭。症状持续时间少于7年、既往手术不超过1次或无直肠受累时，造口关闭的几率显著增加。
