Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa, Nagoya, Aichi, 464-8681, Japan.
Surg Today. 2021 Jul;51(7):1152-1157. doi: 10.1007/s00595-020-02209-x. Epub 2021 Feb 10.
Skin disorders are the most common stoma-related complications after temporary diverting loop ileostomy with proctectomy. The aim of the present study was to investigate risk factors for skin disorders associated with temporary ileostomy construction.
A total of 185 consecutive patients who underwent curative proctectomy with temporary diverting loop ileostomy for rectal malignancies at a single comprehensive cancer center between 2013 and 2018 were collected and analyzed.
The most frequent stoma-related complications were skin disorders (n = 62, 33.5%), followed by mucocutaneous separation (n = 38, 20.5%) and high-output stoma (n = 34, 18.4%). Patients with skin disorders had a higher median body mass index (BMI; 22.4 vs. 21.3 kg/m, P = 0.002) and lower stoma height (16 vs. 20 mm, P < 0.001) than those without skin disorders. According to a multivariable logistic regression analysis, independent predictors of skin disorders included overweight (median BMI ≥ 25 kg/m [odds ratio = 3.6, 95% confidence interval: 1.5-8.6], P = 0.004) and lower stomal height (median stoma height < 20 mm [odds ratio = 3.2, 95% confidence interval: 1.6-6.3], P < 0.001).
Overweight and lower stoma height are correlated with the presence of skin disorders. Construction of a well-elevated stoma can reduce skin disorders associated with temporary ileostomy construction.
在直肠恶性肿瘤行根治性直肠切除+临时性回肠造口术时,皮肤并发症是最常见的造口相关并发症。本研究旨在探讨与临时性回肠造口术相关的皮肤并发症的危险因素。
回顾性分析 2013 年至 2018 年期间,在一家综合性癌症中心接受根治性直肠切除+临时性回肠造口术治疗直肠恶性肿瘤的 185 例患者。
最常见的造口相关并发症是皮肤并发症(62 例,33.5%),其次是黏膜皮肤分离(38 例,20.5%)和高流量造口(34 例,18.4%)。有皮肤并发症的患者的中位体质指数(BMI)较高(22.4 比 21.3kg/m2,P=0.002),造口位置较低(16 比 20mm,P<0.001)。多变量 logistic 回归分析表明,超重(BMI≥25kg/m2[比值比=3.6,95%置信区间:1.5-8.6],P=0.004)和造口位置较低(造口位置<20mm[比值比=3.2,95%置信区间:1.6-6.3],P<0.001)是皮肤并发症的独立预测因素。
超重和较低的造口位置与皮肤并发症的发生有关。构建一个位置较高的造口可以减少与临时性回肠造口术相关的皮肤并发症。