功能性回肠造口术是结直肠癌切除术后小肠梗阻的关键危险因素。
Defunctioning Ileostomy Is a Key Risk Factor for Small Bowel Obstruction After Colorectal Cancer Resection.
作者信息
Eto Ken, Kosuge Makoto, Ohkuma Masahisa, Noaki Rota, Neki Kai, Ito Daisuke, Sugano Hiroshi, Takeda Yasuhiro, Yanaga Katsuhiko
机构信息
Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
出版信息
Anticancer Res. 2018 Mar;38(3):1789-1795. doi: 10.21873/anticanres.12417.
BACKGROUND/AIM: Early postoperative small bowel obstruction (EPSBO) prolongs hospital stays after surgery. This study aimed to evaluate the risk factors for EPSBO associated with colorectal cancer resection.
PATIENTS AND METHODS
We retrospectively compared the clinical variables of patients with EPSBO (n=37) and those without (n=812) after primary tumor resection for colorectal cancer at our hospital between January 2010 and December 2015.
RESULTS
In multivariate analysis, significant differences between the two groups was found in male sex, open surgery, and defunctioning ileostomy (DI) placement (p=0.024, p<0.0001, and p=0.023, respectively), but not for colostomy placement. Of 16 patients with DI who developed EPSBO, 13 (81.3%) cases resulted from obstruction of the stomal outlet.
CONCLUSION
Male sex, open surgery, and DI placement are risk factors for EPSBO after colorectal cancer resection. For patients with placement of DI, obstruction of the stomal outlet should be carefully considered.
背景/目的：术后早期小肠梗阻（EPSBO）会延长手术后的住院时间。本研究旨在评估与结直肠癌切除相关的EPSBO的危险因素。
患者与方法
我们回顾性比较了2010年1月至2015年12月期间在我院接受原发性肿瘤切除术后发生EPSBO的患者（n = 37）和未发生EPSBO的患者（n = 812）的临床变量。
结果
在多变量分析中，发现两组之间在男性、开放手术和放置去功能化回肠造口术（DI）方面存在显著差异（分别为p = 0.024、p < 0.0001和p = 0.023），但在结肠造口术放置方面无差异。在16例发生EPSBO的DI患者中，13例（81.3%）是由造口出口梗阻引起的。
结论
男性、开放手术和DI放置是结直肠癌切除术后EPSBO的危险因素。对于放置DI的患者，应仔细考虑造口出口梗阻问题。
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