Hoffman M S, Gleeson N, Diebel D, Roberts W S, Fiorica J V, Cavanagh D
Department of Obstetrics and Gynecology, Tampa General Hospital, Florida.
Gynecol Oncol. 1993 Jun;49(3):299-302. doi: 10.1006/gyno.1993.1130.
From 7/1/85 to 6/31/92 25 colostomy closures were performed. Twenty-one of the colostomies were performed in relation to gynecologic cancer and the remaining 4 were performed for benign pelvic disease. Nineteen patients underwent simple closure of a transverse loop colostomy. The other 6 patients had their colostomy closed in association with a laparotomy. There were no intraoperative complications related to the colostomy closure. There was 1 postoperative mortality secondary to adult respiratory distress syndrome following reoperation for stricture in the early postoperative period. Three other patients also experienced significant postoperative complications for an overall complication rate of 16%. These included one subcutaneous wound dehiscence, one subcutaneous wound infection, and one anastomotic stricture. One patient required a second colostomy due to recurrence of an obstruction by ovarian cancer in the rectosigmoid area. From the results of this small study, it would appear that colostomy closure is a reasonable endeavor in a selected group of gynecologic cancer patients.
从1985年7月1日至1992年6月31日,共进行了25例结肠造口关闭术。其中21例结肠造口术与妇科癌症有关,其余4例是因良性盆腔疾病而施行。19例患者接受了横袢结肠造口的单纯关闭术。另外6例患者的结肠造口关闭术是在剖腹手术时同时进行的。没有与结肠造口关闭相关的术中并发症。有1例患者在术后早期因狭窄再次手术,继发成人呼吸窘迫综合征而死亡。另外3例患者也出现了严重的术后并发症,总体并发症发生率为16%。这些并发症包括1例皮下伤口裂开、1例皮下伤口感染和1例吻合口狭窄。1例患者因直肠乙状结肠区域卵巢癌复发导致梗阻,需要再次进行结肠造口术。从这项小型研究的结果来看,对于部分选定的妇科癌症患者,结肠造口关闭术似乎是一项合理的手术。