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[结肠造口术的并发症。对500例接受结肠造口术患者的随访研究]

[Complications of colostomies. Follow-up study of 500 colostomized patients].

作者信息

Andivot T, Bail J P, Chio F, Juglard G, Topart P, Lozac'h P, Charles J F

机构信息

Service de Chirugie Digestive, CHU de Brest.

出版信息

Ann Chir. 1996;50(3):252-7.

PMID:8763127
Abstract

The complications of colostomies may constitute a handicap for patients: their prevalence severity and methods of treatment remain poorly known. 500 colostomy patients, with a mean age of 66 +/- 14 years, were retrospectively reviewed. The mean follow-up of the study was 6 +/- 5 years. Colorectal cancers represented 65% of the initial diseases. 59.5% of colostomies were terminal. They were performed for resection of the colon and or rectum in 56.5% of cases. 30.5% of patients (n = 152) presented complications (n = 235). The early complications (n = 147) observed in 29.5% of patients were mostly benign (20 required emergency operations). The late complications (n = 88), observed in 22.5% of 391 patients with a follow-up of more than one year required another operation in 1/3 of cases (11 cases of stenosis, 9 incisional hernias and 8 prolapses). Complications of colostomies remain frequent (one out of every 4 stomies ends in a complication) and the reoperation rate is situated between 13 and 33%. The therapeutic success rate of late reoperation is between 63 and 74%. When a reoperation is necessary, it should be ideally radical via a midline incision. The transposition technique gives better results than the repositioning technique via a local approach.

摘要

结肠造口术的并发症可能会给患者带来不便

其发生率、严重程度及治疗方法仍鲜为人知。对500例平均年龄为66±14岁的结肠造口术患者进行了回顾性研究。该研究的平均随访时间为6±5年。结直肠癌占初始疾病的65%。59.5%的结肠造口术为永久性的。56.5%的病例是为了切除结肠和/或直肠而进行的。30.5%的患者(n = 152)出现了并发症(n = 235)。29.5%的患者出现了早期并发症(n = 147),大多为良性(20例需要急诊手术)。在391例随访超过一年的患者中,22.5%出现了晚期并发症(n = 88),其中1/3的病例(11例狭窄、9例切口疝和8例脱垂)需要再次手术。结肠造口术的并发症仍然很常见(每4个造口中就有1个以并发症告终),再次手术率在13%至33%之间。晚期再次手术的治疗成功率在63%至74%之间。如有必要进行再次手术,理想情况下应通过中线切口进行根治性手术。移位技术比通过局部入路的复位技术效果更好。

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