Wu Di, Wang Bin, Yang Hao
Air Force Medical University, Tangdu Hospital, Department of General Surgery - Xi'an, China.
The 964th Hospital of the Joint Logistics Support Force, Department of Endocrinology - Changchun, China.
Rev Assoc Med Bras (1992). 2025 May 2;71(3):e20241590. doi: 10.1590/1806-9282.20241590. eCollection 2025.
The aim of this study was to investigate independent risk factors for diversion colitis induced by the surgical interruption of fecal flow in the non-functional colon.
We performed a retrospective study with 163 patients who underwent low anterior resections and created prophylactic ileostomies for rectal cancer between January 2014 and June 2023 at the Department of General Surgery, Air Force Medical University Tangdu Hospital. Colonoscopy results of the non-functional region of the distal colon and clinical variables were collected, including age, sex, body mass index, pathological tumor node metastasis staging, ileostomy method, diversion time, receiving radiotherapy or chemotherapy or not, suffering from preoperative inflammatory bowel disease or postoperative anastomotic leakage or not. Diagnosis of diversion colitis based on the results of the patients' colonoscopy results. Univariate analysis and multivariate analysis of diversion colitis-related risk factors were performed subsequently.
The morbidity of diversion colitis is 53.4% (87/163) in our study. Multivariate analysis showed that risk factors for diversion colitis included single-lumen prophylactic ileostomy (63.2 vs. 30.3%, OR 4.481, 95%CI 1.897-10.584, p<0.001), diversion time ≥90 days (79.3 vs. 40.8%, OR 4.474, 95%CI 1.849-10.826, p<0.001), inflammatory bowel disease (17.2 vs. 3.9%, OR 7.491, 95%CI 1.839-30.507, p=0.005), radiotherapy (58.6 vs. 42.1%, OR 0.515, 95%CI 0.196-1.352, p=0.178).
These findings suggest that single-lumen prophylactic ileostomy, diversion time, and inflammatory bowel disease are independent risk factors for diversion colitis.
本研究旨在探讨非功能性结肠粪便流手术中断所致改道性结肠炎的独立危险因素。
我们对2014年1月至2023年6月期间在空军军医大学唐都医院普通外科接受低位前切除术并为直肠癌行预防性回肠造口术的163例患者进行了一项回顾性研究。收集远端结肠非功能性区域的结肠镜检查结果及临床变量，包括年龄、性别、体重指数、病理肿瘤淋巴结转移分期、回肠造口术方法、改道时间、是否接受放疗或化疗、术前是否患有炎症性肠病或术后是否发生吻合口漏。根据患者结肠镜检查结果诊断改道性结肠炎。随后对改道性结肠炎相关危险因素进行单因素分析和多因素分析。
本研究中改道性结肠炎的发病率为53.4%（87/163）。多因素分析显示，改道性结肠炎的危险因素包括单腔预防性回肠造口术（63.2%对30.3%，OR 4.481，95%CI 1.897 - 10.584，p<0.001）、改道时间≥90天（79.3%对40.8%，OR 4.474，95%CI 1.849 - 10.826，p<0.001）、炎症性肠病（17.2%对3.9%，OR 7.491，95%CI 1.839 - 30.507，p = 0.005）、放疗（58.6%对42.1%，OR 0.515，95%CI 0.196 - 1.352，p = 0.178）。
这些发现表明，单腔预防性回肠造口术、改道时间和炎症性肠病是改道性结肠炎的独立危险因素。
