Koc Umit, Karaman Kerem, Gomceli Ismail, Dalgic Tahsin, Ozer Ilter, Ulas Murat, Ercan Metin, Bostanci Erdal, Akoglu Musa
Ostomy Wound Manage. 2017 Jan;63(1):28-32.
Despite advances in surgical techniques and products for stoma care, stoma-related complications are still common. A retrospective analysis was performed of the medical records of 462 consecutive patients (295 [63.9%] female, 167 [36.1 %] male, mean age 55.5 ± 15.1 years, mean body mass index [BMI] 25.1 ± 5.2) who had undergone stoma creation at the Gastroenterological Surgery Clinic of Turkiye Yuksek İhtisas Teaching and Research Hospital between January 2008 and December 2012 to examine the incidence of early (ie, within 30 days after surgery) stoma complications and identify potential risk factors. Variables abstracted included gender, age, and BMI; existence of malignant disease; comorbidities (diabetes mellitus, hypertension, coronary artery disease, chronic respiratory disease); use of neoadjuvant chemoradiotherapy; permanent or temporary stoma; type of stoma (loop/end stoma); stoma localization; and the use of preoperative marking of the stoma site. Data were entered and analyzed using statistical software. Descriptive statistics, chi-squared, and Mann-Whitney U tests were used to describe and analyze all variables, and logistic regression analysis was used to determine independent risk factors for stoma complications. Ostomy-related complications developed in 131 patients (28.4%) Of these, superficial mucocutaneous separation was the most frequent complication (90 patients, 19.5%), followed by stoma retraction (15 patients, 3.2%). In univariate analysis, malignant disease (P = .025), creation of a colostomy (P = .002), and left lower quadrant stoma location (P <.001) were all significant indicators of stoma complication. Only stoma location was an independent risk factor for the development of a stoma complication (P = .044). The rate of stoma complications was not significantly different between patients who underwent nonemergent surgery (30% in patients preoperatively sited versus 28.4% not sited) and patients who underwent emergency surgery (27.1%). Early stoma complication rates were higher in patients with malignant diseases and with colostomies. The site of the stoma is an independent risk factor for the development of stoma complication. Preoperative marking for stoma creation should be considered to reduce the risk of stoma-related complications. Prospective, randomized controlled studies are needed to enhance understanding of the more prevalent risk factors.
尽管造口护理的手术技术和产品有所进步，但造口相关并发症仍然很常见。对2008年1月至2012年12月期间在土耳其尤克斯克伊蒂萨斯教学与研究医院胃肠外科诊所接受造口手术的462例连续患者（295例[63.9%]女性，167例[36.1%]男性，平均年龄55.5±15.1岁，平均体重指数[BMI]25.1±5.2）的病历进行回顾性分析，以检查早期（即术后30天内）造口并发症的发生率并确定潜在风险因素。提取的变量包括性别、年龄和BMI；恶性疾病的存在；合并症（糖尿病、高血压、冠状动脉疾病、慢性呼吸系统疾病）；新辅助放化疗的使用；永久性或临时性造口；造口类型（袢式/端式造口）；造口定位；以及造口部位术前标记的使用。使用统计软件输入和分析数据。描述性统计、卡方检验和曼-惠特尼U检验用于描述和分析所有变量，逻辑回归分析用于确定造口并发症的独立风险因素。131例患者（28.4%）发生了造口相关并发症。其中，浅表黏膜皮肤分离是最常见的并发症（90例，19.5%），其次是造口回缩（15例，3.2%）。在单因素分析中，恶性疾病（P = 0.025）、结肠造口的创建（P = 0.002）和左下腹造口位置（P <0.001）均是造口并发症的显著指标。只有造口位置是造口并发症发生的独立风险因素（P = 0.044）。接受非急诊手术的患者（术前定位患者中为30%，未定位患者中为28.4%）和接受急诊手术的患者（27.1%）之间造口并发症发生率无显著差异。恶性疾病患者和结肠造口患者的早期造口并发症发生率较高。造口部位是造口并发症发生的独立风险因素。应考虑进行造口创建的术前标记以降低造口相关并发症的风险。需要进行前瞻性、随机对照研究以加深对更普遍风险因素的理解。
