Department of Surgery, J. N. Medical College, Aligarh Muslim University, Aligarh, India.
Saudi J Gastroenterol. 2011 Jul-Aug;17(4):271-6. doi: 10.4103/1319-3767.82583.
BACKGROUND/AIM: Loop ileostomy has high complication rates and causes much patient inconvenience. This study was carried out to evaluate the feasibility and outcome of a proximal catheter ileostomy in place of loop ileostomy in patients treated by intestinal repair and/or resection-anastomosis.
Prospective study.
J. N. Medical College Hospital, Aligarh Muslim University, Aligarh, India.
From November 2006 to November 2009, in all patients treated surgically by primary repair and/or resection-anastomosis of small and/or large bowel, we constructed a catheter ileostomy when a defunctioning proximal protective loop ileostomy was considered advisable. Catheter ileostomy was constructed in the fashion of catheter jejunostomy, with postoperative saline irrigation.
Catheter ileostomy was performed in 20 patients in the 3-year period. The mean age of the subjects was 28.6 years and the male: female ratio was 1.86:1. Four patients died of septicemia and multiple organ failure unrelated to catheter ileostomy in the immediate postoperative period. Catheter ileostomy started functioning within 48 hours of the operation, and twice-daily irrigation was found sufficient in 81.25% of the surviving patients. Only one patient developed peritubal leak with mild skin excoriation that cleared within 5 days. Another patient with Koch's abdomen underwent conversion to loop colostomy on re-exploration for postoperative adhesive obstruction. There was no instance of intestinal leak. Ileostomy wounds closed spontaneously within 7-14 days of catheter removal, and none required formal closure. Hospital stay ranged from 12-35 days (mean: 23 days).
Catheter ileostomy is effective in protecting intestinal anastomosis/repair; there is minimal morbidity and no catheter-related leak/mortality, and we recommend the procedure.
背景/目的：回肠袢式造口术并发症发生率高，给患者带来诸多不便。本研究旨在评估在接受肠修复和/或肠切除吻合术的患者中，使用近端导管式造口术替代回肠袢式造口术的可行性和效果。
前瞻性研究。
印度阿拉哈巴德 J.N. 医学院附属医院，阿拉哈巴德穆斯林大学。
自 2006 年 11 月至 2009 年 11 月，在所有接受小肠和/或大肠一期修复和/或切除吻合术治疗的患者中，当认为需要进行预防性近端保护性袢式造口术时，我们构建了导管式造口术。导管式造口术采用导管空肠造口术的方式构建，术后用生理盐水冲洗。
在 3 年期间，有 20 例患者接受了导管式造口术。患者的平均年龄为 28.6 岁，男女比例为 1.86:1。有 4 例患者术后死于与导管式造口术无关的败血症和多器官功能衰竭。导管式造口术在术后 48 小时内开始发挥作用，81.25%的存活患者发现每日冲洗两次即可满足需求。只有 1 例患者出现套管周围漏，伴有轻微皮肤擦伤，5 天内痊愈。另 1 例患有 Koch 腹部的患者因术后粘连性肠梗阻行剖腹探查术转为回肠结肠造口术。没有发生肠漏的情况。导管拔除后，造口伤口在 7-14 天内自然愈合，无需正式缝合。住院时间为 12-35 天（平均：23 天）。
导管式造口术在保护肠吻合/修复方面是有效的；并发症发生率低，且没有与导管相关的漏管/死亡率，我们推荐该方法。
