Department of Gastroenterological Surgery, Faculty of Medicine, Fukuoka University Hospital, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan.
Tech Coloproctol. 2024 May 27;28(1):60. doi: 10.1007/s10151-024-02926-2.
Loop ileostomy is a common surgical procedure but is associated with complications such as outlet obstruction (OO), parastomal hernia (PH), and high-output stoma (HOS). This study aimed to identify risk factors for these complications, as well as their causal relationships.
The study included 188 consecutive patients who underwent loop ileostomy between April 2016 and September 2021. Clinical factors and postoperative stoma-related complications (OO, HOS, and PH) were analyzed retrospectively. Stoma-related factors were evaluated using specific measurements from computed tomography (CT) scans. The incidence, clinical course, and risk factors for the stoma-related complications were investigated.
OO was diagnosed in 28 cases (15.7%), PH in 60 (32%), and HOS in 57 (31.8%). A small longitudinal stoma diameter at the rectus abdominis level on CT and a right-sided stoma were significantly associated with OO. Creation of an ileostomy for anastomotic leakage was independently associated with HOS. Higher body weight and a large longitudinal stoma diameter at the rectus abdominis level on CT were significantly associated with PH. There was a significant relationship between the occurrence of OO and HOS. However, the association between OO and PH was marginal.
This study identified key risk factors for OO, HOS, and PH as complications of loop ileostomy and their causal relationships. Our findings provide insights that may guide the prevention and management of complications related to loop ileostomy.
回肠袢式造口术是一种常见的手术方法，但与出口梗阻（Outlet Obstruction，OO）、造口旁疝（Parastomal Hernia，PH）和高流量造口（High Output Stoma，HOS）等并发症相关。本研究旨在确定这些并发症的风险因素及其因果关系。
本研究纳入了 2016 年 4 月至 2021 年 9 月期间接受回肠袢式造口术的 188 例连续患者。回顾性分析了临床因素和术后与造口相关的并发症（OO、HOS 和 PH）。使用计算机断层扫描（CT）扫描的特定测量值评估与造口相关的因素。研究了与造口相关的并发症的发生率、临床过程和风险因素。
28 例（15.7%）诊断为 OO，60 例（32%）为 PH，57 例（31.8%）为 HOS。CT 上横结肠水平的纵向造口直径较小和右侧造口与 OO 显著相关。为吻合口漏而创建造口术与 HOS 独立相关。较高的体重和 CT 上横结肠水平的较大纵向造口直径与 PH 显著相关。OO 和 HOS 的发生之间存在显著的关系。然而，OO 和 PH 之间的关联是边缘的。
本研究确定了 OO、HOS 和 PH 作为回肠袢式造口术并发症的关键风险因素及其因果关系。我们的研究结果提供了一些见解，可能有助于指导预防和管理与回肠袢式造口术相关的并发症。
