Wang Yuhang, Cheng Lei, Li Weichao, Gao Zhaowei, Miao Jiayuan, Zhang Chunlei, Zhu Zhiqiang, Zhao Feng, Yi Jing, Liu Chunyuan
The Second Clinical Medical College of Binzhou Medical University (Yantai Affiliated Hospital of Binzhou Medical University), Binzhou Medical University, Yantai, China.
Department of Colorectal and Anal Surgery, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China.
Front Med (Lausanne). 2025 Aug 4;12:1610213. doi: 10.3389/fmed.2025.1610213. eCollection 2025.
Enterostomy is widely used in the treatment of various diseases, especially in the treatment of colorectal malignant tumors. It remains to be determined which type of enterostomy can bring more benefits to patients. This study compares the differences in the degrees of benefits for patients between ileostomy and colostomy from multiple dimensions.
In accordance with the PRISMA statement, the databases such as CNKI, PubMed, Embase, and The Cochrane Library were systematically searched for Chinese and English literatures that were publicly published from 2000 to 2025. The literatures were screened according to the established inclusion and exclusion criteria, and the data were independently extracted by two researchers. The Cochrane bias risk assessment tool was used to evaluate the quality of the literatures. RevMan 5.3 was applied for statistical analysis, including heterogeneity test, calculation of values and odds ratios (OR values), assessment of publication bias, and performance of sensitivity analysis.
A total of 630 studies were initially retrieved, and finally 8 randomized controlled trials were included. The quality of the literatures varied. Most of the studies performed well in key aspects, but some had certain defects. After data combination, the final calculation showed that the odds ratio (OR) was 0.43, with a 95% confidence interval (CI) of [0.28, 0.65], and < 0.0001. The analysis results indicated that within the 95% confidence interval, there were significant differences in the incidence rates of various complications between ileostomy and colostomy. Ileostomy had more advantages in reducing the overall complications of enterostomy.
Ileostomy has more advantages than colostomy in reducing the overall complications of enterostomy surgery. This may be related to factors such as anatomical and physiological characteristics, the nature of intestinal contents, the location of the stoma, and surgical procedures. At the same time, complications can be prevented through multiple measures before, during, and after the operation. However, this study has limitations, such as differences among studies, a short follow-up period, and a relatively small number of included studies and patients.
肠造口术在各种疾病的治疗中广泛应用，尤其是在结直肠癌的治疗中。哪种类型的肠造口术能给患者带来更多益处仍有待确定。本研究从多个维度比较回肠造口术和结肠造口术对患者的获益程度差异。
按照PRISMA声明，系统检索中国知网、PubMed、Embase和Cochrane图书馆等数据库中2000年至2025年公开发表的中英文文献。根据既定的纳入和排除标准筛选文献，由两名研究人员独立提取数据。使用Cochrane偏倚风险评估工具评估文献质量。应用RevMan 5.3进行统计分析，包括异质性检验、计算 值和比值比（OR值）、评估发表偏倚以及进行敏感性分析。
最初共检索到630项研究，最终纳入8项随机对照试验。文献质量参差不齐。大多数研究在关键方面表现良好，但有些存在一定缺陷。数据合并后，最终计算得出比值比（OR）为0.43，95%置信区间（CI）为[0.28, 0.65]， < 0.0001。分析结果表明，在95%置信区间内，回肠造口术和结肠造口术各种并发症的发生率存在显著差异。回肠造口术在降低肠造口术总体并发症方面更具优势。
回肠造口术在降低肠造口术手术总体并发症方面比结肠造口术更具优势。这可能与解剖生理特征、肠内容物性质、造口位置和手术操作等因素有关。同时，可通过手术前、手术中和手术后的多种措施预防并发症。然而，本研究存在局限性，如研究之间存在差异、随访期短以及纳入研究和患者数量相对较少。
