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保护性袢式回肠造口关闭术后的发病率和死亡率:可能预测因素的分析

Morbidity and mortality after the closure of a protective loop ileostomy: analysis of possible predictors.

作者信息

Cipe Gokhan, Erkek Bulent, Kuzu Ayhan, Gecim Ethem

机构信息

Bezmialem Vakif University, School of Medicine, Department of General Surgery, Division of Colorectal Surgery, Istanbul, Turkey.

出版信息

Hepatogastroenterology. 2012 Oct;59(119):2168-72. doi: 10.5754/hge12115.

Abstract

BACKGROUND/AIMS: A diverting loop ileostomy is often created to protect distal colorectal, coloanal and ileoanal anastomoses. Ileostomy closure is associated with somewhat morbidity and mortality. The aim of this study was to determine the morbidity and morbidity related factors of ileostomy closure.

METHODOLOGY

Prospectively recorded data of 255 patients who underwent diverting loop ileostomy between October 2000 and May 2011 were analyzed retrospectively.

RESULTS

The study consisted of 139 male and 116 female patients with a median age of 54 years (range 17-79) who underwent ileostomy closure. The morbidity rate of ileostomy closure was 18.4% (47 patients) and the mortality rate was 1.2% (3 patients). When patients with morbidity and without morbidity were compared in terms of gender; age, American Society of Anesthesiology Score, primary pathology, surgeon factor; setting of ileostomy creation and time to stoma closure, only American Society of Anesthesiology Score was found as a predictor for morbidities.

CONCLUSIONS

Closure of loop ileostomy is a simple procedure with low morbidity and a small but significant risk of mortality. Surgeons must consider the known risks in conjunction with the overall benefit/risk analysis before deciding between a temporary fecal diversion and a discontinuous colonic resection.

摘要

背景/目的:通常会做一个转流性回肠造口术来保护远端结直肠、结肠肛管和回肠肛管吻合口。回肠造口关闭术存在一定的发病率和死亡率。本研究的目的是确定回肠造口关闭术的发病率及相关因素。

方法

回顾性分析2000年10月至2011年5月期间255例行转流性回肠造口术患者的前瞻性记录数据。

结果

该研究包括139例男性和116例女性患者,中位年龄54岁(范围17 - 79岁),均接受了回肠造口关闭术。回肠造口关闭术的发病率为18.4%(47例患者),死亡率为1.2%(3例患者)。当比较有并发症和无并发症患者的性别、年龄、美国麻醉医师协会评分、原发病理、外科医生因素、回肠造口创建背景及造口关闭时间时,仅发现美国麻醉医师协会评分是并发症的预测因素。

结论

回肠造口关闭术是一个简单的手术,发病率低,死亡率虽小但有显著风险。在决定是进行临时粪便转流还是间断性结肠切除之前,外科医生必须结合总体效益/风险分析考虑已知风险。

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