Purse-string Stoma Closure: A Case Series Study

荷包口縫合術用於腸造口關閉：病例報告

林敬淳(Ching-Chun Lin) ； 黃郁純(Yu-Chun Huang) ； 張伸吉(Sheng-Chi Chang) ； 江驊哲(Hua-Che Chiang) ； 柯道維(Tao-Wei Ke) ； 王輝明(Hwei-Ming Wang) ； 陳自諒(William Tzu-Liang Chen)

《中華民國大腸直腸外科醫學會雜誌》 28卷4期 (2017/12) Pp. 207-211

https://doi.org/10.6312/SCRSTW.2017.28(4).10619

摘要

Purpose. The present study aimed to assess the wound infection rate and complication rate of our technique for purse-string stoma closure. Materials and Methods. We retrospectively analyzed patients who underwent purse-string stoma closure at China University Hospital between August 2015 and August 2016. We evaluated the surgical-site infection rate, operation time, postoperative admission duration, complications, and wound healing time. Results. Twenty-four patients underwent purse-string stoma closure. The mean operation time was 82.2 ± 27.7 min, and the postoperative admission duration was 4.5 ± 2.3 days. Three cases had postoperative ileus. There was no leakage, wound dehiscence, or surgical-site infection. The mean wound healing time was 27.96 ± 7 days. Conclusions. Purse-string stoma closure is a feasible and easy approach to prevent surgical-site infection.

關鍵字

Purse-string ； Stoma ； Wound infection

並列摘要

目的：觀察及追蹤荷包口縫合術用於造口關閉病人之傷口感染機率及併發症發生機率材料及方法：我們以回朔性分析之方式，於中國醫藥大學附設醫院收集自2015年8月至2016年8月採用荷包口縫合術處理造關閉之所有病人。統計資料包括傷口感染、手術時間、術後住院天數、術後併發症、及傷口癒合天數。結果：共收得24位病人接受荷包口縫合關閉造口。平均手術時間長度為82.2 ± 27.7分鐘；術後平均住院天數為4.5 ± 2.3天；其中有3位病人術後有發生腸阻塞之情形。所有病人均無發生接口滲漏、傷口裂開、傷口感染等問題。平均傷口癒合天數為27.96 ± 7天。結論：荷包口縫合術用於降低關閉造口之傷口感染機率為一種可行、簡易的方式。

並列關鍵字

荷包口縫合術 ； 造口關閉 ； 傷口感染

參考文獻

1. Phang Pt, hain Jm, Perez-Ramirez JJ, madoff RD, Gemlo Bt. techniques and complications of ileostomy takedown. Am J Surg. 1999;177:463-6

2. Feinberg SM, McLeod RS, Cohen Z. Complication of loop ileostomy. Am J Surg. 1987;153(1):102-7.

3. Chow A, Tilney HS, Paraskeva P, Jeyarajah S, Zacharakis E, Purkayastha S. The morbidity surrounding reversal of defunctioning ileostomies: a systematic review of 48 studies including 6,107 cases. Int J Colorectal Dis. 2009;24(6):711-23.

4. Mansfield sD, Jensen C, Phair as, Kelly ot, Kelly sB. Complications of loop ileostomy closure: a retrospective cohort analysis of 123 patients. World J Surg. 2008;32:2101-6.

5. Vermulst N, Vermeulen J, Hazebroek EJ, Coene PP, van der Harst E. Primary closure of the skin after stoma closure. Management of wound infections is easy without (long-term) complications. Dig Surg. 2006;23(4):255-8.