Goetz Andrea, da Silva Natascha Platz Batista, Moser Christian, Agha Ayman, Dendl Lena-Marie, Stroszczynski Christian, Schreyer Andreas G
University Hospital Regensburg, Department of Radiology, Regensburg, Germany.
Clinic Bogenhausen, Munich, Department of General, Visceral, Endocrine and Minimally-Invasice Surgery, Munich, Germany.
Rofo. 2017 Sep;189(9):855-863. doi: 10.1055/s-0043-111598. Epub 2017 Aug 23.
To determine the value of routine contrast enema of loop ileostomy before elective ileostomy closure regarding the influence on the clinical decision-making. Retrospective analysis of contrast enemas at a tertiary care center between 2005 und 2011. Patients were divided into two groups: Group I with ileostomy reversal, group II without ileostomy closure. Patient-related parameters (underlying disease, operation method) and parameters based on the findings (stenosis, leakage of anastomosis, incontinence) were evaluated. Analyzing a total of 252 patients in 89 % (group I, n = 225) ileostomy closure was performed. In 15 % the radiologic report was the only diagnostic modality needed for therapy decision; in 36 % the contrast enema and one or more other diagnostic methods were decisive. In 36 % the radiological report of the contrast imaging was not relevant for decision at all. In 11 % (group II, n = 27) no ileostomy closure was performed. In this group in 11 % the radiological report of the contrast enema was the only decision factor for not performing the ileostomy reversal. In 26 % one or more examination was necessary. In 26 % the result of the contrast examination was not relevant. The radiologic contrast imaging of loop ileostomy solely plays a minor role in complex surgical decision-making before planned reversal, but is important as first imaging method in detecting complications and often leads to additional examinations. · Contrast enema of loop ileostomy before planned ileostomy closure is a frequently performed examination.. · There exist no general guidelines that give further recommendations on decision-making planning ileostomy closure.. · The radiologic contrast imaging of loop ileostomy solely plays a minor role in decision-making before planned reversal, but is important as first imaging method.. · Goetz A, da Silva NP, Moser C et al. Clinical Value of Contrast Enema Prior to Ileostomy Closure. Fortschr Röntgenstr 2017; 189: 855 - 863.
为了确定在择期回肠造口关闭术前进行回肠袢式造口常规对比灌肠对临床决策的影响。对2005年至2011年一家三级医疗中心的对比灌肠进行回顾性分析。患者分为两组：I组进行回肠造口还纳，II组未进行回肠造口关闭。评估患者相关参数（基础疾病、手术方式）以及基于检查结果的参数（狭窄、吻合口漏、失禁）。共分析252例患者，其中89%（I组，n = 225）进行了回肠造口关闭。15%的患者中，放射学报告是治疗决策所需的唯一诊断方式；36%的患者中，对比灌肠和一种或多种其他诊断方法起决定性作用。36%的患者中，对比成像的放射学报告对决策完全无关。11%（II组，n = 27）未进行回肠造口关闭。在该组中，11%的患者中对比灌肠的放射学报告是不进行回肠造口还纳的唯一决定因素。26%的患者需要一项或多项检查。26%的患者中对比检查结果无关。回肠袢式造口的放射学对比成像在计划还纳前的复杂手术决策中仅起次要作用，但作为检测并发症的首选成像方法很重要，且常导致进一步检查。·计划回肠造口关闭术前的回肠袢式造口对比灌肠是一项经常进行的检查。·不存在关于回肠造口关闭决策规划的进一步建议的通用指南。·回肠袢式造口的放射学对比成像在计划还纳前的决策中仅起次要作用，但作为首选成像方法很重要。·戈茨A、达席尔瓦NP、莫泽C等。回肠造口关闭术前对比灌肠的临床价值。《德国放射学杂志》2017年；189: 855 - 863。
