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造口脱垂局部手术效果评估

Evaluation of the Outcome of Local Surgery for Stomal Prolapse.

作者信息

Kosuge Makoto, Ohkuma Masahisa, Koyama Muneyuki, Kobayashi Yasunobu, Nakano Takafumi, Takano Yasuhiro, Shimoyama Yuya, Takada Naoki, Kumamoto Tomotaka, Imaizumi Yuta, Sugano Hiroshi, Eto Seiichiro, Takeda Yasuhiro, Yatabe Saori, Eto Ken

机构信息

Department of Surgery, The Jikei University School of Medicine, 3-19-18, Nishi-shimbashi, Minato-ku, Tokyo 105-8461, Japan.

出版信息

J Clin Med. 2021 Nov 21;10(22):5438. doi: 10.3390/jcm10225438.

Abstract

We reviewed the results of local surgical treatment of stoma prolapse, a long-term complication of stoma construction. Fifteen patients treated for stomal prolapse between 2009 and 2020 at the authors' and affiliated hospitals were included in this study. The treatment comprised local laparotomic stomal reconstruction (LLSR) in nine patients and stapling repair (SR) in six. We compared and evaluated the clinical and surgical information and postoperative complications. Operation time was significantly shorter in the SR group than in the LLSR group: 20 and 53 min, respectively ( = 0.036). The duration of postoperative hospitalization was shorter in the SR group than in the LLSR group: 5.5 and 8 days, respectively; the difference was not significant ( = 0.088). No short-term complications were found in either group. Regarding long-term, postoperative complications, parastomal hernias developed after 2.5 years in one patient in the LLSR group and after 6 months in one patient in the SR group; both patients had histories of parastomal hernia surgery and had relatively high body mass indices. Local surgery for stomal prolapse was minimally invasive and performed safely. In patients with a history of surgery for parastomal hernia, attention must be paid to the potential of parastomal hernia developing as a postoperative complication.

摘要

我们回顾了造口脱垂(造口术的一种长期并发症)的局部手术治疗结果。本研究纳入了2009年至2020年期间在作者所在医院及附属医院接受造口脱垂治疗的15例患者。治疗方法包括9例患者接受局部剖腹造口重建术(LLSR)和6例患者接受吻合器修复术(SR)。我们比较并评估了临床和手术信息以及术后并发症。SR组的手术时间明显短于LLSR组,分别为20分钟和53分钟(P = 0.036)。SR组的术后住院时间短于LLSR组,分别为5.5天和8天;差异无统计学意义(P = 0.088)。两组均未发现短期并发症。关于长期术后并发症,LLSR组有1例患者在2.5年后发生造口旁疝,SR组有1例患者在6个月后发生造口旁疝;这两名患者均有造口旁疝手术史且体重指数相对较高。造口脱垂的局部手术微创且安全。对于有造口旁疝手术史的患者,必须注意造口旁疝作为术后并发症发生的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eaa4/8622099/730d042478ec/jcm-10-05438-g001.jpg

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