直肠癌的脐旁回肠造口术可降低切口疝的风险。
Umbilical Defunctioning Ileostomy for Rectal Cancer Results in Reduced Risk for Incisional Hernia.
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. 2020 Jun;40(6):3445-3451. doi: 10.21873/anticanres.14330.
BACKGROUND/AIM: Umbilical defunctioning ileostomy (UDI) spares one incision, which may reduce the overall incidence of incisional hernia. Our aim was to evaluate the occurrence and risk factors of incisional hernias between UDI and conventional defunctioning ileostomy (CDI) after ileostomy closure.
PATIENTS AND METHODS
Incidence of incisional hernia after ileostomy closure was compared between UDI (n=51) and CDI (n=86) groups. Risk factors for incisional hernia were also considered through a retrospective analysis.
RESULTS
The overall incidence of incisional hernia was 5.9% in the UDI group, which was significantly lower than the 22.1% (7.0% at the midline incision and 15.1% at the stoma site) in the CDI group (p=0.012). Multivariate analysis showed higher BMI (p=0.035) and CDI (p=0.031) as risk factors for developing incisional hernias overall.
CONCLUSION
UDI results in fewer incisional hernias than CDI and seems to be superior to CDI from the standpoint of overall incidence of incisional hernias.
背景/目的：回肠预防性造口术（UDI）可避免一处切口，这可能会降低切口疝的总体发生率。我们的目的是评估预防性回肠造口还纳术后 UDI 与传统预防性回肠造口术（CDI）之间切口疝的发生和危险因素。
患者和方法
比较了预防性回肠造口还纳术后 UDI（n=51）和 CDI（n=86）两组切口疝的发生率。通过回顾性分析还考虑了切口疝的危险因素。
结果
UDI 组切口疝的总发生率为 5.9%，明显低于 CDI 组的 22.1%（中线切口为 7.0%，造口部位为 15.1%）（p=0.012）。多因素分析显示，较高的 BMI（p=0.035）和 CDI（p=0.031）是总体发生切口疝的危险因素。
结论
UDI 导致的切口疝少于 CDI，从切口疝总体发生率的角度来看，UDI 似乎优于 CDI。
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