van de Pavoordt H D, Fazio V W, Jagelman D G, Lavery I C, Weakley F L
Department of Colorectal Surgery, Cleveland Clinic Foundation.
Int J Colorectal Dis. 1987 Nov;2(4):214-7. doi: 10.1007/BF01649508.
Our experience with closure of loop ileostomies between the years 1975-1986 was reviewed. Ninety-three percent of stoma closures were done by simple transverse suture. The overall complication rate was 17%. Of the early postoperative complications (13%), the major complication was small bowel obstruction especially in patients where the stoma was protecting a pelvic ileal reservoir. Abdominal septic complications (postclosure) were rare (1%). These were generally caused by unrecognized enteric tears during the mobilization of the stoma rather than anastomotic leakage. A careful operative technique is required. The wound infection rate after healing by both secondary intention and primary skin closure was low (3%) and mainly superficial. Only one incisional hernia was observed in the late postoperative period. In three patients a posterior rectus sheath defect at the stoma site was found incidentally at laparotomy, without clinical evidence of an incisional hernia. Closure of a loop ileostomy is a safe operation with a low morbidity. In patients with a previous total colectomy there was a significant risk of small bowel obstruction after ileostomy closure.
我们回顾了1975年至1986年间回肠袢式造口关闭术的经验。93%的造口关闭采用简单的横向缝合。总体并发症发生率为17%。术后早期并发症（13%）中，主要并发症是小肠梗阻，尤其是造口用于保护盆腔回肠贮袋的患者。腹部感染性并发症（造口关闭后）很少见（1%）。这些通常是由于造口游离过程中未被识别的肠壁撕裂，而非吻合口漏所致。需要仔细的手术技巧。二期愈合和一期皮肤缝合后的伤口感染率较低（3%），且主要为浅表感染。术后晚期仅观察到1例切口疝。3例患者在剖腹手术时偶然发现造口部位的腹直肌后鞘缺损，无切口疝的临床证据。回肠袢式造口关闭术是一种安全的手术，发病率较低。既往有全结肠切除术的患者，回肠造口关闭后发生小肠梗阻的风险显著增加。
