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老年患者行临时性回肠造口术的安全性和可行性:一项回顾性研究。

Safety and Feasibility of Temporary Ileostomy in Older Patients: A Retrospective Study.

机构信息

Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Aichi, Japan.

出版信息

Wound Manag Prev. 2022 Jul;68(7):18-24.

Abstract

BACKGROUND

Temporary ileostomy reduces the incidence of severe anastomotic leakage and postoperative mortality. However, little is known about ileostomy-related complications in older adults.

PURPOSE

To clarify the safety and feasibility of temporary ileostomy for rectal cancer in older patients.

METHODS

Data were collected from a prospectively created database and complemented by secondary chart review for consecutive patients with rectal malignancy who underwent curative proctectomy with diverting loop ileostomy between 2013 and 2018. Ileostomy construction and closure were compared between two groups (defined as elderly and non-elderly patients). Data for 22 patients who were 75 years of age and older (elderly group) and 160 patients who were younger than 75 years (non-elderly group) were analyzed.

RESULTS

The median maximum fecal output was significantly higher in the non-elderly group compared with the elderly group. No significant differences were observed between the two groups in postoperative intravenous hydration, creatinine ratio, and ileostomy-related complication rate. Although the elderly group had a higher rate of early stoma closure, the causes were not related to those complications.

CONCLUSION

Temporary ileostomy was a safe and feasible procedure in this population of older patients with rectal malignancies.

摘要

背景

临时肠造口术可降低严重吻合口漏和术后死亡率的发生率。然而,对于老年人中肠造口术相关并发症知之甚少。

目的

阐明在老年患者中进行直肠癌临时性肠造口术的安全性和可行性。

方法

从 2013 年至 2018 年连续进行根治性直肠切除术和预防性回肠造口术的前瞻性创建数据库中收集数据,并通过二次图表审查进行补充。比较两组(定义为老年和非老年患者)的肠造口术构建和关闭情况。分析了 22 名年龄在 75 岁及以上(老年组)和 160 名年龄小于 75 岁(非老年组)的患者的数据。

结果

非老年组的最大粪便输出量中位数明显高于老年组。两组在术后静脉补液、肌酐比和肠造口相关并发症发生率方面无显著差异。尽管老年组早期肠造口关闭率较高,但原因与这些并发症无关。

结论

对于患有直肠恶性肿瘤的老年患者,临时性肠造口术是一种安全可行的方法。

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