Department of General Surgery, Infanta Elena University Clinical Hospital, 21080 Huelva, Spain.
Department of General Surgery, Juan Ramón Jiménez University Clinical Hospital, 21005 Huelva, Spain.
Nutrients. 2021 Feb 15;13(2):626. doi: 10.3390/nu13020626.
Loop ileostomy closure after colorectal surgery is often associated with Postoperative ileus, with an incidence between 13-20%. The aim of this study is to evaluate the efficacy and safety of preoperative stimulation of the efferent loop with probiotics prior to ileostomy closure in patients operated on for colorectal carcinoma. For this, a prospective, randomized, double-blind, controlled study is designed. All patients who underwent surgery for colorectal carcinoma with loop ileostomy were included. Randomized and divided into two groups, 34 cases and 35 controls were included in the study. Postoperative ileus, the need for nasogastric tube insertion, the time required to begin tolerating a diet, restoration of bowel function, and duration of hospital stay were evaluated. The incidence of Postoperative ileus was similar in both groups, 9/34 patients stimulated with probiotics and 10/35 in the control group (CG) with a = 0.192. The comparative analysis showed a direct relationship between Postoperative ileus after oncological surgery and Postoperative ileus after reconstruction surgery, independently of stimulation. Postoperative ileus after closure ileostomy is independent of stimulation of the ileostomy with probiotics through the efferent loop. There seem to be a relationship between Postoperative ileus after reconstruction and the previous existence of Postoperative ileus after colorectal cancer surgery.
结直肠手术后的回肠造口关闭常伴有术后肠梗阻，发病率为 13-20%。本研究旨在评估术前刺激回肠造口输出襻中益生菌对接受结直肠癌手术患者行回肠造口关闭术的疗效和安全性。为此，设计了一项前瞻性、随机、双盲、对照研究。所有接受结直肠旁置回肠造口术的结直肠癌患者均纳入研究。随机分为两组，34 例和 35 例对照组纳入研究。评估术后肠梗阻、需要插入鼻胃管、开始耐受饮食的时间、肠功能恢复和住院时间。两组术后肠梗阻发生率相似，益生菌刺激组 9/34 例，对照组 10/35 例（CG）=0.192。对比分析显示，肿瘤手术后的术后肠梗阻与重建手术后的术后肠梗阻直接相关，与刺激无关。回肠造口关闭术后的术后肠梗阻与通过输出襻刺激回肠造口的益生菌刺激无关。重建手术后的术后肠梗阻与结直肠癌手术后先前存在的术后肠梗阻之间似乎存在关系。
