Nour S, Beck J, Stringer M D
Department of Paediatric Surgery, Leeds General Infirmary.
Ann R Coll Surg Engl. 1996 Nov;78(6):526-30.
This study analyses the morbidity and mortality of colostomy formation and closure over a 17-year period during which 138 consecutive infants and children had a colostomy formed as the initial management of Hirschsprung's disease or anorectal malformation. Complications after colostomy formation were encountered in 38 (27.5%) patients and included colostomy prolapse, stenosis, retraction, dysfunction, skin excoriation and parastomal hernia. The complication rate with transverse colostomies was higher than with other types. Colostomy closure was associated with complications in nine patients (6.5%), the most serious of which was adhesive small bowel obstruction (5). The mortality was less than 1%, but significant morbidity still exists. Refinements in surgical technique may help reduce the incidence of complications, but stoma prolapse, particularly with transverse colostomies, remains a major challenge.
本研究分析了17年间结肠造口术形成与关闭的发病率和死亡率，在此期间，连续138例婴儿和儿童接受了结肠造口术，作为先天性巨结肠或肛门直肠畸形的初始治疗方法。38例（27.5%）患者出现结肠造口术后并发症，包括结肠造口脱垂、狭窄、回缩、功能障碍、皮肤擦伤和造口旁疝。横结肠造口术的并发症发生率高于其他类型。9例患者（6.5%）结肠造口关闭时出现并发症，其中最严重的是粘连性小肠梗阻（5例）。死亡率低于1%，但仍存在明显的发病率。手术技术的改进可能有助于降低并发症的发生率，但造口脱垂，尤其是横结肠造口术引起的造口脱垂，仍然是一个重大挑战。
