肠造口并发症在坏死性小肠结肠炎 (NEC) 手术中的回顾性图表分析。
Enterostomy complications in necrotizing enterocolitis (NEC) surgery, a retrospective chart review at Odense University Hospital.
机构信息
Surgical Department A, Odense University Hospital, J.B. Winsløws Vej 4, 5000, Odense C, Denmark.
OPEN, Odense Patient data Explorative Network, Odense, Denmark.
出版信息
BMC Pediatr. 2019 Apr 13;19(1):110. doi: 10.1186/s12887-019-1488-5.
BACKGROUND
The aim was to investigate the incidence of postoperative complications to surgery for necrotizing enterocolitis (NEC) with primary focus on enterostomy related complications.
METHODS
A retrospective chart review of surgically treated NEC during the period from 2008 to 2014 was performed. Enterostomy with secondary anastomosis was our standard treatment. Postoperative complications were classified according to the Clavien-Dindo Classification (CDC).
RESULTS
Forty-two cases were included in the study. NEC was most frequently located in the small bowel and the length of resected intestine was median 15 cm (2-50). Thirty-nine (93%) patients received an ileostomy and the rest a colostomy. Twenty-two (52%) patients underwent a total of 35 reoperations, and 25 (71%) of these were stoma related with stenosis was the most frequent cause, other causes of reoperation were re-NEC, high-output ileostomy, Ileus and second look.
CONCLUSIONS
The rate of reoperation due to complications was high and most often caused by stoma related complications.
背景
本研究旨在调查新生儿坏死性小肠结肠炎（NEC）手术的术后并发症发生率，重点关注肠造口相关并发症。
方法
回顾性分析了 2008 年至 2014 年期间手术治疗 NEC 的病例。肠造口二期吻合术是我们的标准治疗方法。术后并发症的分类采用 Clavien-Dindo 分类（CDC）。
结果
本研究共纳入 42 例患者。NEC 最常发生于小肠，切除肠段的长度中位数为 15cm（2-50cm）。39 例（93%）患者行肠造口术，其中 1 例行结肠造口术。22 例（52%）患者共进行了 35 次再次手术，其中 25 次（71%）与造口相关，狭窄是最常见的原因，其他再手术的原因包括再发 NEC、高输出性肠造口、肠梗阻和二次探查。
结论
因并发症而再次手术的发生率较高，且常由造口相关并发症引起。
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