Department of General Surgery, Virginia Commonwealth University Medical Center, Richmond, VA, USA.
Department of Surgery, Division of Colon and Rectal Surgery, Virginia Commonwealth University Medical Center, Richmond, VA, USA.
Am Surg. 2023 Nov;89(11):4930-4933. doi: 10.1177/00031348211047483. Epub 2021 Sep 25.
When surgery requires a colorectal anastomosis, a diverting ostomy may be created to decrease the clinical impact of anastomotic failure. Unfortunately, diverting ileostomies are also associated with significant morbidity. Recent literature suggests that diverting ostomies are not necessary for the majority of patients undergoing colorectal anastomosis and that creation of a virtual ileostomy (VI) may spare patients the complications that accompany diverting ileostomy creation. We present 4 patients with complex medical histories who underwent colorectal resections with primary anastomoses and VI creation. None of these patients suffered anastomotic leak or required conversion of VI to defunctioning ileostomy and there were no major complications associated with VI creation. Our results, although limited by sample size, support the creation of a virtual ileostomy as a safe and effective alternative to diverting ileostomy creation at the time of colorectal anastomosis.
当手术需要进行结直肠吻合时，可能会创建一个转流性肠造口术，以降低吻合失败的临床影响。不幸的是，转流性回肠造口术也会导致显著的发病率。最近的文献表明，对于大多数接受结直肠吻合术的患者来说，转流性肠造口术并非必需，而且创建虚拟回肠造口术（VI）可能会使患者免受转流性回肠造口术相关并发症的困扰。我们报告了 4 例具有复杂病史的患者，他们接受了结直肠切除术和原发吻合术以及 VI 术的创建。这些患者均未发生吻合口漏，也无需将 VI 转换为功能性回肠造口术，而且 VI 术的创建没有出现与主要并发症相关的问题。尽管我们的结果受到样本量的限制，但支持将虚拟回肠造口术作为结直肠吻合时转流性回肠造口术的安全有效的替代方法。
