Surgical Department, Fürst Stirum Klinik Bruchsal, Gutleutstrasse 1-14, 76646, Bruchsal, Germany.
Int J Colorectal Dis. 2011 May;26(5):623-6. doi: 10.1007/s00384-010-1086-3. Epub 2010 Dec 24.
Creation of a temporary loop ileostomy is a standard surgical procedure. This study was undertaken to determine whether dehydration associated with the ileostomy causes renal impairment.
The prospective data from 107 consecutive patients undergoing temporary loop ileostomy between 2004 and 2009 was evaluated. GFR was calculated at the time of hospital discharge after constructing the ileostomy and at the time of deciding to close the ileostomy.
The average GFR at the time of discharge after constructing the ileostomy was a median of 92.50 (60.75-223.88); at the time of deciding to close the ileostomy, it was 75.25 (4-135.13) ml/min/1.73 m(2) (p < 0.001). In 20 patients renal function decreased, with a GFR <60 ml/min/1.73 m(2) during the ileostomy period; in six of these 20 patients, the decrease was severe (GFR <30 ml/min/1.73 m(2)). Underlying diseases, reasons for constructing ileostomies, sex, and time interval to closure did not affect renal function. Patients in whom GFR was decreased at the time of deciding to close the ileostomy presented with significantly more closure-related surgical complications.
Renal impairment is a well-known potential complication of loop ileostomy. To avoid this complication, close control and backup support is recommended in these patients.
创建临时回肠造口术是一种标准的手术程序。本研究旨在确定与回肠造口术相关的脱水是否会导致肾功能损害。
评估了 2004 年至 2009 年间连续 107 例接受临时回肠造口术的患者的前瞻性数据。在构建回肠造口术出院时和决定关闭回肠造口术时计算肾小球滤过率(GFR)。
构建回肠造口术后出院时的平均 GFR 中位数为 92.50(60.75-223.88);决定关闭回肠造口术时,GFR 为 75.25(4-135.13)ml/min/1.73 m2(p<0.001)。在 20 名患者中,肾功能下降,在回肠造口期间 GFR<60 ml/min/1.73 m2;在这 20 名患者中的 6 名中,下降严重(GFR<30 ml/min/1.73 m2)。基础疾病、造口术的原因、性别和关闭时间间隔均未影响肾功能。在决定关闭回肠造口术时 GFR 降低的患者,其与关闭相关的手术并发症明显更多。
肾功能损害是回肠造口术的一个已知潜在并发症。为避免这种并发症,建议对这些患者进行密切监测和备用支持。