Hussein Nadia L, Stevenson Autumn P, Lawton Catherine F, Elmayan Ardem, Hillis Emma E, Burton Jeffrey H, Fuhrman George
Department of Surgery, Inova Fairfax Hospital, Falls Church, VA, USA.
The University of Queensland Medical School, Ochsner Clinical School, New Orleans, LA, USA.
Am Surg. 2023 Sep;89(9):3870-3872. doi: 10.1177/00031348231173971. Epub 2023 May 5.
A diverting loop ileostomy (DLI) is used to protect a distal gastrointestinal anastomosis at risk of leakage. While patients typically prefer early DLI closure, surgeons vary in opinion regarding optimal timing. This study evaluated whether the timing of DLI closure impacts outcomes.A retrospective review was performed on patients who underwent DLI creation within one health care system between 2012 and 2020. Patient characteristics and postoperative outcomes were compared across ileostomies closed in ≤2 months, 2-4 months, and >4 months. Outcomes examined included anastomotic leak, other complications, reintervention, and death within 30 days.A total of 500 DLIs were analyzed for the study, 455 of which were closed. The three closure groups were similar in patient characteristics and comorbidities. None of the outcome variables analyzed in this study demonstrated a statistically significant difference between groups, suggesting that in patients otherwise fit for surgery, DLI closure can be safely performed within 2 months of creation.
转流性回肠造口术(DLI)用于保护有渗漏风险的远端胃肠道吻合口。虽然患者通常倾向于早期关闭DLI,但外科医生对于最佳时机的看法不一。本研究评估了DLI关闭的时机是否会影响预后。
对2012年至2020年在一个医疗系统内接受DLI造口术的患者进行了回顾性研究。比较了在≤2个月、2 - 4个月和>4个月内关闭回肠造口术患者的特征和术后结果。检查的结果包括吻合口漏、其他并发症、再次干预和30天内死亡情况。
本研究共分析了500例DLI,其中455例已关闭。三个关闭组在患者特征和合并症方面相似。本研究分析的所有结果变量在组间均未显示出统计学上的显著差异,这表明对于其他适合手术的患者,DLI可在造口术后2个月内安全关闭。