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[结肠造口关闭术:它是一种无风险的干预措施吗?]

[Colostomy closure: is it an intervention without risk?].

作者信息

Paredes J P, Caínzos M, García J, Parada P, Fernández E, Paulos A, Potel J

机构信息

Servicio de Cirugía General, Hospital General de Galicia, Universidad de Santiago de Compostela.

出版信息

Rev Esp Enferm Dig. 1994 Oct;86(4):733-7.

PMID:7986613
Abstract

OBJECTIVE

To examine whether colostomy closure is an operation with a high risk of complications.

DESIGN

Retrospective study of colostomy closures in a 14-year period.

PARTICIPANTS

60 patients, averaging 54 years, males in 63%. The main indication for colostomy was colorectal neoplasm (47%), followed by trauma (23%).

RESULTS

There were 15 Hartman's procedure reconstructions, 4 reconstructions of colostomy and mucous fistula, and 41 "simple" colostomy closures. The closure was extraperitoneal in 40%, suturing only the anterior colonic wall in 42%. We had 27 postoperative complications in 33% of the patients, without mortality. The average hospital stay was 8 days longer in the group with complications. The complication rate was 29% in the "simple" closure versus 42% in the reconstruction group (this difference was not statistically significant). The statistic analysis (chi-square and Mann-Whitney tests) showed no influence on morbidity of factors such as age, sex, previous disease, age of colostomy, and type and closure technique of colostomy.

CONCLUSIONS

Colostomy closure has a high rate of postoperative complications (33%). These are minor in almost all cases, without mortality.

摘要

目的

探讨结肠造口关闭术是否为高并发症风险手术。

设计

对14年间结肠造口关闭术进行回顾性研究。

参与者

60例患者,平均年龄54岁,63%为男性。结肠造口的主要指征是结直肠肿瘤(47%),其次是创伤(23%)。

结果

有15例哈特曼手术重建,4例结肠造口与黏液瘘重建,41例“单纯”结肠造口关闭术。40%的关闭术为腹膜外操作,42%仅缝合结肠前壁。33%的患者出现27例术后并发症,无死亡病例。有并发症的患者组平均住院时间延长8天。“单纯”关闭术的并发症发生率为29%,重建组为42%(差异无统计学意义)。统计分析(卡方检验和曼-惠特尼检验)显示,年龄、性别、既往疾病、结肠造口时间、结肠造口类型及关闭技术等因素对发病率无影响。

结论

结肠造口关闭术术后并发症发生率较高(33%)。几乎所有病例的并发症都较轻微,无死亡病例。

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