Horesh Nir, Hoffman Aviad, Zager Yaniv, Cordoba Mordechai, Haikin Marat, Rosin Danny, Gutman Mordechai, Lebedeyev Alexander
Department of Surgery and Transplantation, Sheba Medical Center, Tel Hashomer, affiliated with the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Isr Med Assoc J. 2019 Nov;21(11):728-731.
Evaluation of low rectal anastomosis is often recommended prior to ostomy closure, but the efficacy of such evaluations is uncertain.
To assess whether routine colonic preoperative evaluation has an effect on postoperative ileostomy closure results.
We performed a retrospective study evaluating all patients who underwent ileostomy closure over 9 years. Patient demographics, clinical, surgical details, and surgical outcomes were recorded and analyzed.
The study comprised 116 patients who underwent ileostomy closure, of them 65 were male (56%) with a mean age of 61 years (range 20-91). Overall, 98 patients (84.4%) underwent colonic preoperative evaluation prior to ileostomy closure. A contrast enema was performed on 61 patients (62.2%). Abnormal preoperative results were observed in 12 patients (12.2%). The overall complication rate was 35.3% (41 patients). No differences in postoperative outcome was observed in patient gender (P = 1), age (P = 0.96), body mass index (P = 0.24), American Society of Anesthesiologists score (P = 0.21), and the Charlson Comorbidity Index score (P = 0.93). Among patients who had postoperative complications, we did not observe a difference between patients who underwent preoperative evaluation compared to those who did not (P = 0.42). No differences were observed among patients with preoperative findings interpreted as normal or abnormal (P = 1). The time difference between ileostomy creation and closure had no effect on the ileostomy closure outcome (P = 0.34).
Abnormal findings in preoperative colonic evaluation prior to ileostomy closure were not associated with worse postoperative outcome.
在造口关闭术前常建议对低位直肠吻合口进行评估，但此类评估的疗效尚不确定。
评估常规结肠术前评估对术后回肠造口关闭结果是否有影响。
我们进行了一项回顾性研究，评估了9年间所有接受回肠造口关闭术的患者。记录并分析了患者的人口统计学资料、临床和手术细节以及手术结果。
该研究包括116例行回肠造口关闭术的患者，其中65例为男性（56%），平均年龄61岁（20 - 91岁）。总体而言，98例患者（84.4%）在回肠造口关闭术前接受了结肠术前评估。61例患者（62.2%）进行了对比灌肠。12例患者（12.2%）术前结果异常。总体并发症发生率为35.3%（41例患者）。在患者性别（P = 1）、年龄（P = 0.96）、体重指数（P = 0.24）、美国麻醉医师协会评分（P = 0.21）和查尔森合并症指数评分（P = 0.93）方面，术后结果未观察到差异。在有术后并发症的患者中，我们未观察到接受术前评估的患者与未接受术前评估的患者之间存在差异（P = 0.42）。术前检查结果被解释为正常或异常的患者之间未观察到差异（P = 1）。回肠造口造口与关闭之间的时间差对回肠造口关闭结果没有影响（P = 0.34）。
回肠造口关闭术前结肠评估中的异常发现与更差的术后结果无关。
