Yao Hongwei, An Yongbo, Zhang Zhongtao
Department of General Surgery, Beijing Friendship Hospital, National Clinical Research Centre of Digestive Diseases, Capital Medical University, 95 Yong'an Road, Xi-Cheng District, Beijing, 100050, China.
Surg Today. 2019 Jun;49(6):451-459. doi: 10.1007/s00595-018-1736-6. Epub 2018 Nov 27.
Defunctioning stomas are frequently used by colorectal surgeons after unsatisfactory anastomosis. The primary purpose of constructing a defunctioning stoma is to prevent an anastomotic leakage or to alleviate the detrimental consequences of it. However, the construction of defunctioning stomas is not free and is associated with adverse impacts on the patient. Stoma-related complications can develop in different stages and can impair a patient's quality of life. Furthermore, one in every four to six defunctioning stomas turns into a non-closure stoma. Since no definite indications for the creation of a defunctioning stoma are available, surgeons have to carefully weigh their benefits against their adverse effects. Thus, the precise selection of patients who should undergo the creation of a defunctioning stoma is of great importance, and an alternative method for preventing anastomotic leakage is needed.
在结直肠吻合术效果不理想后,结直肠外科医生经常会使用去功能化造口。构建去功能化造口的主要目的是预防吻合口漏或减轻其不良后果。然而,构建去功能化造口并非毫无代价,且会给患者带来不利影响。与造口相关的并发症可在不同阶段出现,并会损害患者的生活质量。此外,每四到六个去功能化造口中就有一个会变成永久性造口。由于目前尚无明确的去功能化造口创建指征,外科医生必须仔细权衡其益处与不良影响。因此,精确选择应接受去功能化造口创建的患者至关重要,并且需要一种预防吻合口漏的替代方法。