Hsu Chao-Wen, Chang Min-Chi, Wang Jui-Ho, Wu Chih-Chien, Chen Yu-Hsun
Division of Colorectal Surgery, Department of Surgery, Kaohsiung Veteran General Hospital, 386 Ta-Chung 1st RD, Kaohsiung, Taiwan, 81346, Republic of China.
Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.
Int J Colorectal Dis. 2019 Mar;34(3):513-518. doi: 10.1007/s00384-018-03229-3. Epub 2019 Jan 7.
A temporary loop stoma is often created after laparoscopic colorectal cancer surgery. Peristomal adhesions may make stoma closure into a complicated operation. We demonstrated how to place the SurgiWrap® adhesion barrier film and evaluated the peristomal adhesion severity and feasibility of stoma closure.
This is a retrospective case-control study. Patients were divided into a study group (placement of adhesion barrier film) and a control group (no placement). Patient characteristics, operative data, and severity of adhesions were recorded. We used logistic regression to probe the association between the variables and the adhesion severity.
A total of 180 patients were identified with 60 in the study group and 120 in the control group. In the study group, the adhesion severity (p < 0.001), operative time (p = 0.025), and time to flatus (p = 0.042) are significantly reduced. In logistic regression analysis, placement of the film (p < 0.001), neoadjuvant concurrent chemoradiotherapy (p = 0.041), and time interval between stoma creation and closure ≧ 12 weeks (p = 0.038) are three significant factors influencing the peristomal adhesion.
The placement of SurgiWrap® adhesion barrier film around the loop stoma after laparoscopic colorectal cancer surgery may reduce the peristomal adhesion severity and facilitate the stoma closure in terms of operative time and time to flatus.
腹腔镜结直肠癌手术后常需创建临时性袢式造口。造口周围粘连可能使造口关闭成为一项复杂手术。我们展示了如何放置SurgiWrap®粘连屏障膜,并评估了造口周围粘连的严重程度及造口关闭的可行性。
这是一项回顾性病例对照研究。患者被分为研究组(放置粘连屏障膜)和对照组(未放置)。记录患者特征、手术数据及粘连严重程度。我们使用逻辑回归来探究变量与粘连严重程度之间的关联。
共纳入180例患者,研究组60例,对照组120例。研究组的粘连严重程度(p<0.001)、手术时间(p = 0.025)及排气时间(p = 0.042)均显著降低。在逻辑回归分析中,放置该膜(p<0.001)、新辅助同步放化疗(p = 0.041)以及造口创建与关闭之间的时间间隔≥12周(p = 0.038)是影响造口周围粘连的三个显著因素。
腹腔镜结直肠癌手术后在袢式造口周围放置SurgiWrap®粘连屏障膜可能会降低造口周围粘连的严重程度,并在手术时间和排气时间方面促进造口关闭。