General Surgery Department, Santa Maria della Misericordia Hospital, Rovigo, Italy.
General Surgery Department, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milano, Italy.
World J Emerg Surg. 2023 Oct 10;18(1):48. doi: 10.1186/s13017-023-00516-5.
BACKGROUND: The creation of an ileostomy or colostomy is a common surgical event, both in elective and in emergency context. The main aim of stoma creation is to prevent postoperative complications, such as the anastomotic leak. However, stoma-related complications can also occur and their morbidity is not negligible, with a rate from 20 to 70%. Most stomal complications are managed conservatively, but, when this approach is not resolutive, surgical treatment becomes necessary. The aim of this mapping review is to get a comprehensive overview on the incidence, the risk factors, and the management of the main early and late ostomy complications: stoma necrosis, mucocutaneous separation, stoma retraction, stoma prolapse, parastomal hernia, stoma stenosis, and stoma bleeding. MATERIAL AND METHODS: A complete literature research in principal databases (PUBMED, EMBASE, SCOPUS and COCHRANE) was performed by Multidisciplinary Italian Study group for STOmas (MISSTO) for each topic, with no language restriction and limited to the years 2011-2021. An international expert panel, from MISSTO and World Society of Emergency Surgery (WSES), subsequently reviewed the different issues, endorsed the project, and approved the final manuscript. CONCLUSION: Stoma-related complications are common and require a step-up management, from conservative stoma care to surgical stoma revision. A study of literature evidence in clinical practice for stoma creation and an improved management of stoma-related complications could significantly increase the quality of life of patients with ostomy. Solid evidence from the literature about the correct management is lacking, and an international consensus is needed to draw up new guidelines on this subject.
背景:肠造口术或结肠造口术是一种常见的手术,无论是在择期手术还是紧急情况下都需要进行。造口的主要目的是预防术后并发症,如吻合口漏。然而,也可能会发生与造口相关的并发症,其发病率不容忽视,约为 20%至 70%。大多数造口并发症可通过保守治疗来管理,但如果这种方法无效,则需要进行手术治疗。本次映射综述的目的是全面了解主要早期和晚期造口并发症的发生率、危险因素和处理方法:造口坏死、黏膜皮肤分离、造口回缩、造口脱垂、造口旁疝、造口狭窄和造口出血。
材料和方法:意大利多学科肠造口术研究组(MISSTO)在主要数据库(PUBMED、EMBASE、SCOPUS 和 COCHRANE)中对每个主题进行了全面的文献检索,无语言限制,检索年限限于 2011 年至 2021 年。MISSTO 和世界急诊外科学会(WSES)的一个国际专家小组随后审查了不同的问题,认可了该项目,并批准了最终的手稿。
结论:造口相关并发症很常见,需要进行分级管理,从保守的造口护理到手术造口修复。对造口术创建和造口相关并发症的管理进行临床实践中的文献研究,并进行改进,可显著提高造口患者的生活质量。文献中缺乏关于正确管理的确凿证据,需要制定新的指南,以就这一主题达成国际共识。
World J Emerg Surg. 2023-10-10
Tech Coloproctol. 2019-10-12
Cochrane Database Syst Rev. 2019-4-24
J Wound Ostomy Continence Nurs.
Dis Colon Rectum. 1998-12
J Wound Ostomy Continence Nurs. 2020
Br J Nurs. 2021-12-9
Medicine (Baltimore). 2025-7-11
World J Emerg Surg. 2025-3-29
Inflamm Bowel Dis. 2025-8-1
Int J Emerg Med. 2022-5-9
Langenbecks Arch Surg. 2021-6
J Wound Ostomy Continence Nurs.
J Wound Ostomy Continence Nurs.
Cureus. 2020-10-29
World J Surg Oncol. 2020-10-22
Am J Surg. 2020-2-16