Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Japan.
Department of Nursing, Gunma University Hospital, Maebashi, Japan.
Anticancer Res. 2023 Sep;43(9):4189-4195. doi: 10.21873/anticanres.16610.
BACKGROUND/AIM: Determination of risk factors for stoma-related complications associated with emergency stoma creation may impact on reducing complications and improving the quality of life of ostomy patients; however, there are only few reports on stoma-related complications associated with emergency stoma creation. Our study aimed to identify risk factors associated with stoma-related complications after emergency surgery, and evaluate surgical techniques for good stoma creation in the emergency setting.
A retrospective analysis of patient and surgical characteristics was performed in 104 consecutive patients who underwent ileostomy or colostomy as emergency surgery between January 2020 and December 2022 at the Gunma University Hospital.
Preoperative stoma site marking was performed in 70 (67.3%) patients. Colostomies and ileostomies were performed in 78 (75.0%) and 26 (25.0%) patients, respectively. The skin bridge technique was used in 13 (12.5%) patients. Stoma-related complications were diagnosed in 62 (59.6 %) patients, with peristomal skin disorders (47.1%) as the most common complication, followed by mucocutaneous separation (31.7%), and stoma retraction (19.2%). In the multivariate analysis, body mass index (BMI) [odds ratio (OR)=5.570, 95% confidence interval (CI)=1.233-25.167, p=0.026], skin bridge technique (OR=0.144, 95% CI=0.031-0.670, p=0.014), and stoma height (OR=0.134, 95% CI=0.038-0.469, p=0.002) were independent risk factors for stoma-related complications after emergency stoma creation.
In emergency stoma creation, higher BMI and lower stoma height are associated with stoma-related complications. Using the skin bridge technique could reduce the risk of stoma-related complications after emergency stoma creation.
背景/目的：确定与急诊造口相关的并发症的危险因素可能会降低并发症的发生率并提高造口患者的生活质量；然而，仅有少数关于与急诊造口相关的并发症的报告。我们的研究旨在确定与急诊手术后造口相关并发症相关的危险因素，并评估在急诊环境下良好造口创建的手术技术。
对 2020 年 1 月至 2022 年 12 月在群马大学医院接受急诊肠造口术的 104 例连续患者的患者和手术特征进行回顾性分析。
70 例（67.3%）患者进行了术前造口部位标记。行结肠造口术和回肠造口术的患者分别为 78 例（75.0%）和 26 例（25.0%）。13 例（12.5%）患者采用了皮桥技术。诊断出 62 例（59.6%）患者发生造口相关并发症，以肛周皮肤疾病（47.1%）为最常见的并发症，其次为黏膜皮肤分离（31.7%）和造口回缩（19.2%）。多因素分析显示，体重指数（BMI）[比值比（OR）=5.570，95%置信区间（CI）=1.233-25.167，p=0.026]、皮桥技术（OR=0.144，95%CI=0.031-0.670，p=0.014）和造口高度（OR=0.134，95%CI=0.038-0.469，p=0.002）是急诊造口后造口相关并发症的独立危险因素。
在急诊造口术中，较高的 BMI 和较低的造口高度与造口相关并发症相关。使用皮桥技术可以降低急诊造口后造口相关并发症的风险。
