Sarkut Pinar, Dundar Halit Ziya, Tirnova Ismail, Ozturk Ersin, Yilmazlar Tuncay
Department of General Surgery, Faculty of Medicine, Uludağ University, Görükle, Turkey.
Int J Gen Med. 2015 Aug 18;8:243-6. doi: 10.2147/IJGM.S79224. eCollection 2015.
Performing transient or permanent ileostomy is one of the common procedures involved in colorectal surgery. Complication rates up to 40% have been reported in ileostomies. In this report, the effect of specific stoma care unit on ileostomy and its complications were investigated.
A total of 141 patients, who were operated and underwent ileostomy, due to different causes, at Department of General Surgery, Uludağ University, Bursa, Turkey, between 2003 and 2006, were examined, retrospectively. Patient records were examined in terms of age, sex, surgery indications, urgent/elective state, benign/malign origin, ileostomy type, complications and stoma care, and education. χ(2) test was used to compare the categorical data.
Among the patients, 95 (67%) were male and 46 (33%) were female. The mean age was 47 years (17-67). Some of the subjects (49%) were operated urgently and some (51%) were under elective conditions. The ileostomy types used included the following: end ileostomy (43%), loop ileostomy (46%), and double-barrel ileostomy (11%). Permanent ileostomy was performed in 23 patients and transient ileostomy was performed in 118 patients. The patients were operated because of either benign (48%) or malign (52%) causes. Complications developed in 37 (26%) patients. The rate of development of complication was markedly higher in ileostomies performed under urgent conditions (61% vs 39%) (P<0.001). The complications included mucocutaneous separation (12 patients), maceration in the peristomal skin (ten patients), retraction (five patients), necrosis (three patients), prolapsus (three patients), and other metabolic complications (four patients). The complications were treated with care (68%) and surgical revision (32%).
The rate of ileostomy was found to be higher in the male patients compared to female patients. The risk of development of complications was found to be higher in ileostomies performed under urgent conditions. The most common complication observed was mucocutaneous separation. Ileostomy complications can be treated conservatively with professional care and education.
进行暂时性或永久性回肠造口术是结直肠手术中常见的操作之一。据报道，回肠造口术的并发症发生率高达40%。在本报告中，研究了特定造口护理单元对回肠造口术及其并发症的影响。
回顾性研究了2003年至2006年期间在土耳其布尔萨乌鲁达格大学普通外科因不同原因接受手术并进行回肠造口术的141例患者。检查患者记录的年龄、性别、手术指征、急诊/择期情况、良性/恶性病因、回肠造口术类型、并发症及造口护理和教育情况。采用χ²检验比较分类数据。
患者中，男性95例（67%），女性46例（33%）。平均年龄为47岁（17 - 67岁）。部分患者（49%）为急诊手术，部分患者（51%）为择期手术。使用的回肠造口术类型包括：末端回肠造口术（43%）、袢式回肠造口术（46%）和双腔回肠造口术（11%）。23例患者进行了永久性回肠造口术，118例患者进行了暂时性回肠造口术。患者手术原因包括良性（48%）或恶性（52%）病因。37例（26%）患者出现并发症。急诊情况下进行的回肠造口术并发症发生率明显更高（61%对39%）（P<0.001）。并发症包括黏膜皮肤分离（12例患者）、造口周围皮肤浸渍（10例患者）、回缩（5例患者）、坏死（3例患者）、脱垂（3例患者）和其他代谢并发症（4例患者）。并发症通过护理（68%）和手术修复（32%）进行治疗。
发现男性患者的回肠造口术发生率高于女性患者。急诊情况下进行的回肠造口术发生并发症的风险更高。观察到的最常见并发症是黏膜皮肤分离。回肠造口术并发症可通过专业护理和教育进行保守治疗。
