Miyo Masaaki, Takemasa Ichiro, Ikeda Masataka, Tujie Masaki, Hasegawa Junichi, Ohue Masayuki, Kato Takeshi, Mizushima Tsunekazu, Doki Yuichiro, Mori Masaki
Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
Department of Surgery, Surgical Oncology and Science, Sapporo Medical University, S-1, W-17, Chuo-ku, Sapporo, Hokkaido, 060-8556, Japan.
Surg Today. 2017 Aug;47(8):940-950. doi: 10.1007/s00595-017-1481-2. Epub 2017 Mar 9.
The association between technical maneuvers in fashioning a diverting loop-ileostomy and stoma-related complications remains unclear. Thus, this study aimed to evaluate their relevance to stoma-related morbidity.
This retrospective multicenter study was designed to collect data from 37 institutions. We evaluated the perioperative outcomes of consecutive patients who underwent surgery to create a diverting loop-ileostomy in 2013.
A total of 4137 patients with colorectal disease underwent colorectomy, 279 of whom received an ileostomy. The results of these 279 patients were analyzed. The most common complications were parastomal dermatitis (n = 132) followed by ileus (n = 36), mucocutaneous separation (n = 24), parastomal hernia (n = 16), stoma retraction (n = 15), and stoma prolapse (n = 9). The technical maneuvers used in the creation of ileostomies were heterogeneous and some had a great deal of relevance to the complications. A long distance from the ileocecal valve to the ileostomy was associated with a low risk of stoma retraction and a high risk of ileus. Additionally, the height of the distal limb of the ileostomy significantly affected the incidence of parastomal dermatitis and mucocutaneous separation.
Specific technical maneuvers that are utilized in the creation of diverting loop-ileostomies had a significant influence on the incidence of stoma-related morbidities. Our findings emphasize the possibility of minimizing stoma-related complications with appropriate surgical techniques.
构建转流性袢式回肠造口术的技术操作与造口相关并发症之间的关联尚不清楚。因此，本研究旨在评估它们与造口相关发病率的相关性。
这项回顾性多中心研究旨在收集来自37个机构的数据。我们评估了2013年连续接受手术创建转流性袢式回肠造口术患者的围手术期结局。
共有4137例结直肠疾病患者接受了结直肠切除术，其中279例接受了回肠造口术。对这279例患者的结果进行了分析。最常见的并发症是造口旁皮炎（n = 132），其次是肠梗阻（n = 36）、黏膜皮肤分离（n = 24）、造口旁疝（n = 16）、造口回缩（n = 15）和造口脱垂（n = 9）。创建回肠造口术所使用的技术操作各不相同，有些与并发症有很大关联。从回盲瓣到回肠造口的距离较长与造口回缩风险低和肠梗阻风险高相关。此外，回肠造口远端肢体的高度显著影响造口旁皮炎和黏膜皮肤分离的发生率。
构建转流性袢式回肠造口术时使用的特定技术操作对造口相关发病率有重大影响。我们的研究结果强调了通过适当的手术技术将造口相关并发症降至最低的可能性。
