Department of Gastrointestinal Surgery, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China; Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Ohio, United States.
Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Ohio, United States.
Int J Surg. 2017 Jul;43:52-55. doi: 10.1016/j.ijsu.2017.05.039. Epub 2017 May 22.
The optimal timing for the closure of loop ileostomies remains controversial. The aim of this study is to determine whether ileostomy closure (<3 months post formation) affects stoma-related morbidity compared to late closure (≥3 months post formation).
All patients who had loop ileostomy and ileostomy closure between 2012 and 2015 were identified from an IRB-approved, prospectively maintained institutional database.The patients who underwent ileostomy closure (<3 months) were compared against matched patients undergoing ileostomy closure (≥3 months). The outcomes for the two groups were compared.
A total of 358 patients were analyzed. Mean age was 46 ± 17 years. There were 179 patients in each group [ileostomy closure (<3 months) and ileostomy closure (≥3 months)]. Both groups were matched. Groups were comparable in preoperative characteristics and demographics. All of the peri-operative variables were comparable. No difference was observed in estimated blood loss (EBL), operative time (OT) and length of stay (LOS) (all p > 0.05). Postoperative outcomes including wound infection, post-operative bleeding, intra-abdominal abscess, ileus, small bowel obstruction (SBO), anastomotic leak, reoperation, surgery related readmission, postoperative transfusion were also similar among the groups (p > 0.05).
Ileostomy closure (<3 months) is practical and safe. It does not increase morbidity and significantly reduces the time patient has a stoma. This may be advantageous in regards to having a reduced possibility of stoma related complications.
回肠袢式造口的关闭最佳时机仍存在争议。本研究旨在确定与晚期关闭（形成后≥3 个月）相比，造口关闭（形成后<3 个月）是否会影响与造口相关的发病率。
从经 IRB 批准的前瞻性维护机构数据库中确定了 2012 年至 2015 年间所有接受回肠袢式造口术和造口关闭术的患者。将接受造口关闭术（<3 个月）的患者与接受造口关闭术（≥3 个月）的匹配患者进行比较。比较两组的结果。
共分析了 358 例患者。平均年龄为 46±17 岁。每组 179 例患者[造口关闭（<3 个月）和造口关闭（≥3 个月）]。两组均匹配。两组在术前特征和人口统计学方面具有可比性。所有围手术期变量均具有可比性。未观察到估计失血量（EBL）、手术时间（OT）和住院时间（LOS）的差异（均 p>0.05）。术后结果包括伤口感染、术后出血、腹腔脓肿、肠梗阻、小肠梗阻（SBO）、吻合口漏、再次手术、与手术相关的再入院、术后输血，两组之间也相似（p>0.05）。
造口关闭（<3 个月）是实用且安全的。它不会增加发病率，并显著减少患者带造口的时间。这可能有利于减少与造口相关的并发症的可能性。
